•  Summary 
  •  
  •  Actions 
  •  
  •  Committee Votes 
  •  
  •  Floor Votes 
  •  
  •  Memo 
  •  
  •  Text 
  •  
  •  LFIN 
  •  
  •  Chamber Video 

S03148 Summary:

BILL NOS03148A
 
SAME ASSAME AS A02646-A
 
SPONSORSAVINO
 
COSPNSRALCANTARA, AVELLA, BAILEY, CARLUCCI, CROCI, HAMILTON, HOYLMAN, KAMINSKY, LATIMER, PERALTA, ROBACH, SANDERS, VALESKY
 
MLTSPNSR
 
Amd 3216, 3221 & 4303, Ins L
 
Relates to insurance coverage of in vitro fertilization and other fertility preservation treatments.
Go to top

S03148 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         3148--A
 
                               2017-2018 Regular Sessions
 
                    IN SENATE
 
                                    January 20, 2017
                                       ___________
 
        Introduced  by Sens. SAVINO, ALCANTARA, AVELLA, BAILEY, CARLUCCI, CROCI,
          HAMILTON, HOYLMAN, KAMINSKY, LATIMER, PERALTA, ROBACH, VALESKY -- read
          twice and ordered printed, and when printed to  be  committed  to  the
          Committee  on Insurance -- committee discharged, bill amended, ordered
          reprinted as amended and recommitted to said committee

        AN ACT to amend the insurance law, in relation to insurance coverage  of
          in vitro fertilization and other fertility preservation treatments
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Paragraph 13 of subsection  (i)  of  section  3216  of  the
     2  insurance  law is amended by adding three new subparagraphs (C), (D) and
     3  (E) to read as follows:
     4    (C) Every policy delivered or issued for delivery in this  state  that
     5  provides  coverage  for hospital, surgical or medical care shall provide
     6  coverage for:
     7    (i) in vitro fertilization used in the treatment of infertility; and
     8    (ii) standard fertility preservation services when a necessary medical
     9  treatment may directly or indirectly cause iatrogenic infertility  to  a
    10  covered person.
    11    (D)  (i)  For  the  purposes  of  subparagraph  (C) of this paragraph,
    12  "infertility" means a disease or condition characterized by the incapac-
    13  ity to impregnate another person or to conceive, as diagnosed or  deter-
    14  mined (I) by a physician licensed to practice medicine in this state, or
    15  (II)  by  the  failure  to  establish  a clinical pregnancy after twelve
    16  months of regular, unprotected sexual intercourse, or after  six  months
    17  of regular, unprotected sexual intercourse in the case of a female thir-
    18  ty-five years of age or older.
    19    (ii)  For  the purposes of subparagraph (C) of this paragraph, "iatro-
    20  genic infertility" means an impairment of fertility  by  surgery,  radi-
    21  ation,  chemotherapy  or  other medical treatment affecting reproductive
    22  organs or processes.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04562-04-7

        S. 3148--A                          2
 
     1    (E) No insurer providing coverage under this paragraph shall discrimi-
     2  nate based on a covered individual's expected length of life, present or
     3  predicted disability, degree of medical dependency, perceived quality of
     4  life, or other health conditions, nor based on personal characteristics,
     5  including age, sex, sexual orientation, marital status or gender identi-
     6  ty.
     7    §  2.  Paragraph  6 of subsection (k) of section 3221 of the insurance
     8  law is amended by adding three new subparagraphs (E),  (F)  and  (G)  to
     9  read as follows:
    10    (E)  Every group policy delivered or issued for delivery in this state
    11  that provides hospital,  surgical  or  medical  coverage  shall  provide
    12  coverage for:
    13    (i) in vitro fertilization used in the treatment of infertility; and
    14    (ii) standard fertility preservation services when a necessary medical
    15  treatment  may  directly or indirectly cause iatrogenic infertility to a
    16  covered person.
    17    (F) (i) For the  purposes  of  subparagraph  (E)  of  this  paragraph,
    18  "infertility" means a disease or condition characterized by the incapac-
    19  ity  to impregnate another person or to conceive, as diagnosed or deter-
    20  mined (I) by a physician licensed to practice medicine in this state, or
    21  (II) by the failure to  establish  a  clinical  pregnancy  after  twelve
    22  months  of  regular, unprotected sexual intercourse, or after six months
    23  of regular, unprotected sexual intercourse in the case of a female thir-
    24  ty-five years of age or older.
    25    (ii) For the purposes of subparagraph (E) of this  paragraph,  "iatro-
    26  genic  infertility"  means  an impairment of fertility by surgery, radi-
    27  ation, chemotherapy or other medical  treatment  affecting  reproductive
    28  organs or processes.
    29    (G) No insurer providing coverage under this paragraph shall discrimi-
    30  nate based on a covered individual's expected length of life, present or
    31  predicted disability, degree of medical dependency, perceived quality of
    32  life, or other health conditions, nor based on personal characteristics,
    33  including age, sex, sexual orientation, marital status or gender identi-
    34  ty.
    35    §  3.  Subsection (s) of section 4303 of the insurance law, as amended
    36  by section 2 of part F of chapter 82 of the laws of 2002, is amended  by
    37  adding three new paragraphs (5), (6) and (7) to read as follows:
    38    (5)  Every contract issued by a medical expense indemnity corporation,
    39  hospital service corporation or health service corporation for  delivery
    40  in this state that provides hospital, surgical or medical coverage shall
    41  provide coverage for:
    42    (A) in vitro fertilization used in the treatment of infertility; and
    43    (B)  standard fertility preservation services when a necessary medical
    44  treatment may directly or indirectly cause iatrogenic infertility  to  a
    45  covered person.
    46    (6) (A) For the purposes of paragraph five of this subsection, "infer-
    47  tility"  means a disease or condition characterized by the incapacity to
    48  impregnate another person or to conceive, as diagnosed or determined (i)
    49  by a physician licensed to practice medicine in this state, or  (ii)  by
    50  the  failure  to  establish  a clinical pregnancy after twelve months of
    51  regular, unprotected sexual intercourse, or after six months of regular,
    52  unprotected sexual intercourse in the case of a female thirty-five years
    53  of age or older.
    54    (B) For the purposes of paragraph five of this subsection, "iatrogenic
    55  infertility" means an impairment of  fertility  by  surgery,  radiation,

        S. 3148--A                          3
 
     1  chemotherapy or other medical treatment affecting reproductive organs or
     2  processes.
     3    (7)  No medical expense indemnity corporation, hospital service corpo-
     4  ration or health  service  corporation  providing  coverage  under  this
     5  subsection  shall  discriminate based on a covered individual's expected
     6  length of life, present  or  predicted  disability,  degree  of  medical
     7  dependency,  perceived  quality of life, or other health conditions, nor
     8  based on personal characteristics, including  age,  sex,  sexual  orien-
     9  tation, marital status or gender identity.
    10    § 4. Subparagraph (C) of paragraph 6 of subsection (k) of section 3221
    11  of the insurance law, as amended by section 1 of part K of chapter 82 of
    12  the laws of 2002, is amended to read as follows:
    13    (C)   Coverage  of  diagnostic  and  treatment  procedures,  including
    14  prescription drugs, used in the diagnosis and treatment  of  infertility
    15  as  required  by  subparagraphs  (A)  and (B) of this paragraph shall be
    16  provided in accordance with the provisions of this subparagraph.
    17    (i) [Coverage shall be provided for  persons  whose  ages  range  from
    18  twenty-one  through forty-four years, provided that nothing herein shall
    19  preclude the provision of coverage to persons  whose  age  is  below  or
    20  above such range.
    21    (ii)]  Diagnosis  and  treatment of infertility shall be prescribed as
    22  part of a physician's overall plan  of  care  and  consistent  with  the
    23  guidelines for coverage as referenced in this subparagraph.
    24    [(iii)]  (ii)  Coverage may be subject to co-payments, coinsurance and
    25  deductibles as may be deemed appropriate by the  superintendent  and  as
    26  are  consistent with those established for other benefits within a given
    27  policy.
    28    [(iv) Coverage shall be limited to those  individuals  who  have  been
    29  previously covered under the policy for a period of not less than twelve
    30  months,  provided  that for the purposes of this subparagraph "period of
    31  not less than twelve months" shall be  determined  by  calculating  such
    32  time from either the date the insured was first covered under the exist-
    33  ing policy or from the date the insured was first covered by a previous-
    34  ly in-force converted policy, whichever is earlier.
    35    (v)] (iii) Coverage shall not be required to include the diagnosis and
    36  treatment  of  infertility  in connection with: (I) [in vitro fertiliza-
    37  tion, gamete intrafallopian tube transfers or zygote intrafallopian tube
    38  transfers; (II)] the reversal of elective sterilizations;  [(III)]  (II)
    39  sex  change  procedures;  [(IV)] (III) cloning; or [(V)] (IV) medical or
    40  surgical services or procedures that are deemed to  be  experimental  in
    41  accordance  with clinical guidelines referenced in clause [(vi)] (iv) of
    42  this subparagraph.
    43    [(vi)] (iv) The superintendent, in consultation with the  commissioner
    44  of health, shall promulgate regulations which shall stipulate the guide-
    45  lines  and  standards which shall be used in carrying out the provisions
    46  of this subparagraph, which shall include:
    47    (I) [The determination of "infertility" in accordance with the  stand-
    48  ards  and  guidelines established and adopted by the American College of
    49  Obstetricians and Gynecologists and the American Society  for  Reproduc-
    50  tive Medicine;
    51    (II)] The identification of experimental procedures and treatments not
    52  covered  for  the  diagnosis  and treatment of infertility determined in
    53  accordance with the standards and guidelines established and adopted  by
    54  the American College of Obstetricians and Gynecologists and the American
    55  Society for Reproductive Medicine;

        S. 3148--A                          4
 
     1    [(III)]  (II)  The identification of the required training, experience
     2  and other standards for health  care  providers  for  the  provision  of
     3  procedures and treatments for the diagnosis and treatment of infertility
     4  determined  in  accordance with the standards and guidelines established
     5  and  adopted  by the American College of Obstetricians and Gynecologists
     6  and the American Society for Reproductive Medicine; and
     7    [(IV)] (III) The determination of appropriate  medical  candidates  by
     8  the  treating  physician in accordance with the standards and guidelines
     9  established and adopted by the American  College  of  Obstetricians  and
    10  Gynecologists and/or the American Society for Reproductive Medicine.
    11    §  5.  Paragraph  3 of subsection (s) of section 4303 of the insurance
    12  law, as amended by section 2 of part K of chapter  82  of  the  laws  of
    13  2002, is amended to read as follows:
    14    (3)   Coverage  of  diagnostic  and  treatment  procedures,  including
    15  prescription drugs used in the diagnosis and treatment of infertility as
    16  required by paragraphs one and two of this subsection shall be  provided
    17  in accordance with this paragraph.
    18    (A)  [Coverage  shall  be  provided  for persons whose ages range from
    19  twenty-one through forty-four years, provided that nothing herein  shall
    20  preclude  the  provision  of  coverage  to persons whose age is below or
    21  above such range.
    22    (B)] Diagnosis and treatment of infertility  shall  be  prescribed  as
    23  part  of  a  physician's  overall  plan  of care and consistent with the
    24  guidelines for coverage as referenced in this paragraph.
    25    [(C)] (B) Coverage may be  subject  to  co-payments,  coinsurance  and
    26  deductibles  as  may  be deemed appropriate by the superintendent and as
    27  are consistent with those established for other benefits within a  given
    28  policy.
    29    [(D)  Coverage  shall  be  limited  to those individuals who have been
    30  previously covered under the policy for a period of not less than twelve
    31  months, provided that for the purposes of this paragraph "period of  not
    32  less  than  twelve  months" shall be determined by calculating such time
    33  from either the date the insured was first covered  under  the  existing
    34  policy  or  from  the date the insured was first covered by a previously
    35  in-force converted policy, whichever is earlier.
    36    (E)] (C) Coverage shall not be required to include the  diagnosis  and
    37  treatment  of  infertility  in connection with: (i) [in vitro fertiliza-
    38  tion, gamete intrafallopian tube transfers or zygote intrafallopian tube
    39  transfers; (ii)] the reversal of elective sterilizations;  [(iii)]  (ii)
    40  sex  change  procedures;  [(iv)] (iii) cloning; or [(v)] (iv) medical or
    41  surgical services or procedures that are deemed to  be  experimental  in
    42  accordance with clinical guidelines referenced in subparagraph [(F)] (D)
    43  of this paragraph.
    44    [(F)] (D) The superintendent, in consultation with the commissioner of
    45  health,  shall  promulgate  regulations which shall stipulate the guide-
    46  lines and standards which shall be used in carrying out  the  provisions
    47  of this paragraph, which shall include:
    48    (i)  [The determination of "infertility" in accordance with the stand-
    49  ards and guidelines established and adopted by the American  College  of
    50  Obstetricians  and  Gynecologists and the American Society for Reproduc-
    51  tive Medicine;
    52    (ii)] The identification of experimental procedures and treatments not
    53  covered for the diagnosis and treatment  of  infertility  determined  in
    54  accordance  with the standards and guidelines established and adopted by
    55  the American College of Obstetricians and Gynecologists and the American
    56  Society for Reproductive Medicine;

        S. 3148--A                          5
 
     1    [(iii)] (ii) The identification of the required  training,  experience
     2  and  other  standards  for  health  care  providers for the provision of
     3  procedures and treatments for the diagnosis and treatment of infertility
     4  determined in accordance with the standards and  guidelines  established
     5  and  adopted  by the American College of Obstetricians and Gynecologists
     6  and the American Society for Reproductive Medicine; and
     7    [(iv)] (iii) The determination of appropriate  medical  candidates  by
     8  the  treating  physician in accordance with the standards and guidelines
     9  established and adopted by the American  College  of  Obstetricians  and
    10  Gynecologists and/or the American Society for Reproductive Medicine.
    11    §  6.  This  act  shall  take  effect on the first day of January next
    12  succeeding the date on which it shall have become a law and shall  apply
    13  to  all  policies  issued, renewed, altered or modified on or after such
    14  date.
Go to top