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A02695 Summary:

BILL NOA02695
 
SAME ASNo Same As
 
SPONSORDurso
 
COSPNSRAngelino, Brown E, Sempolinski, Yeger, McDonough, Novakhov, Tague, Maher, DeStefano, Cunningham, Gandolfo, Manktelow
 
MLTSPNSRPalmesano
 
Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L
 
Requires certain health insurance plans cover annual electrocardiograms for covered children under the age of nineteen.
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A02695 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          2695
 
                               2025-2026 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 22, 2025
                                       ___________
 
        Introduced  by M. of A. DURSO -- read once and referred to the Committee
          on Insurance
 
        AN ACT to amend the insurance  law  and  the  social  services  law,  in
          relation  to  requiring  certain  health  insurance plans cover annual
          electrocardiograms for covered children under the age of nineteen

          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1. Clauses (ii) and (iii) of subparagraph (B) of paragraph 17
     2  of subsection (i) of section 3216 of the insurance law,  as  amended  by
     3  chapter  219  of  the laws of 2011, are amended and a new clause (iv) is
     4  added to read as follows:
     5    (ii) at each visit, services in accordance with the  prevailing  clin-
     6  ical  standards  of  such  designated  association,  including a medical
     7  history, a  complete  physical  examination,  developmental  assessment,
     8  anticipatory  guidance,  appropriate  immunizations and laboratory tests
     9  which tests are ordered at the time of the visit and  performed  in  the
    10  practitioner's  office, as authorized by law, or in a clinical laborato-
    11  ry; [and]
    12    (iii) necessary immunizations, as determined by the superintendent  in
    13  consultation  with  the  commissioner  of health, consisting of at least
    14  adequate dosages of  vaccine  against  diphtheria,  pertussis,  tetanus,
    15  polio,  measles, rubella, mumps, haemophilus influenzae type b and hepa-
    16  titis b, which meet the standards approved by the United  States  public
    17  health service for such biological products[.]; and
    18    (iv) an electrocardiogram test and an interpretation of the results of
    19  such  test  at least once annually and with greater frequency if ordered
    20  by a physician or other licensed professional whose  scope  of  practice
    21  under  title eight of the education law provides the authority to admin-
    22  ister such a test, in accordance with prevailing clinical standards.
    23    § 2. Clauses (ii) and (iii) of subparagraph  (B)  of  paragraph  8  of
    24  subsection (l) of section 3221 of the insurance law, as amended by chap-
    25  ter  219 of the laws of 2011, are amended and a new clause (iv) is added
    26  to read as follows:
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05728-01-5

        A. 2695                             2
 
     1    (ii) at each visit, services in accordance with the  prevailing  clin-
     2  ical  standards  of  such  designated  association,  including a medical
     3  history, a  complete  physical  examination,  developmental  assessment,
     4  anticipatory  guidance,  appropriate  immunizations and laboratory tests
     5  which  tests  are  ordered at the time of the visit and performed in the
     6  practitioner's office, as authorized by law, or in a clinical  laborato-
     7  ry; [and]
     8    (iii)  necessary immunizations, as determined by the superintendent in
     9  consultation with the commissioner of health,  consisting  of  at  least
    10  adequate  dosages  of  vaccine  against  diphtheria, pertussis, tetanus,
    11  polio, measles, rubella, mumps, haemophilus influenzae type b and  hepa-
    12  titis  b,  which meet the standards approved by the United States public
    13  health service for such biological products[.]; and
    14    (iv) an electrocardiogram test and an interpretation of the results of
    15  such test at least once annually and with greater frequency  if  ordered
    16  by  a  physician  or other licensed professional whose scope of practice
    17  under title eight of the education law provides the authority to  admin-
    18  ister such a test, in accordance with prevailing clinical standards.
    19    §  3.  Subparagraphs  (B)  and (C) of paragraph 2 of subsection (j) of
    20  section 4303 of the insurance law, as amended by chapter 219 of the laws
    21  of 2011, are amended and a new subparagraph (C-1) is added  to  read  as
    22  follows:
    23    (B) at each visit, services in accordance with the prevailing clinical
    24  standards of such designated association, including a medical history, a
    25  complete  physical  examination,  developmental assessment, anticipatory
    26  guidance, appropriate immunizations and laboratory tests which tests are
    27  ordered at the time of the visit and  performed  in  the  practitioner's
    28  office, as authorized by law, or in a clinical laboratory, [and]
    29    (C)  necessary  immunizations,  as determined by the superintendent in
    30  consultation with the commissioner of health,  consisting  of  at  least
    31  adequate  dosages  of  vaccine  against  diphtheria, pertussis, tetanus,
    32  polio, measles, rubella, mumps, haemophilus influenzae type b and  hepa-
    33  titis  b,  which meet the standards approved by the United States public
    34  health service for such biological products[.], and
    35    (C-1) an electrocardiogram test and an interpretation of  the  results
    36  of  such  test  at  least  once  annually  and with greater frequency if
    37  ordered by a physician or other licensed  professional  whose  scope  of
    38  practice  under  title eight of the education law provides the authority
    39  to administer such a test, in accordance with prevailing clinical stand-
    40  ards.
    41    § 4. Subdivision 2 of section 365-a of  the  social  services  law  is
    42  amended by adding a new paragraph (t-1) to read as follows:
    43    (t-1)  screening,  including an electrocardiogram test and interpreta-
    44  tion of the results of such test in children eighteen years  of  age  or
    45  under, at least once annually and with greater frequency if ordered by a
    46  physician  or  other licensed professional whose scope of practice under
    47  title eight of the education law provides the  authority  to  administer
    48  such  a  test  and if done in accordance with prevailing clinical stand-
    49  ards; provided, however, that the provisions of this paragraph  relating
    50  to  electrocardiogram  tests  shall not take effect unless all necessary
    51  approvals under federal law and regulation have been obtained to receive
    52  federal financial participation in the costs of such services.
    53    § 5. This act shall take effect immediately and  shall  apply  to  any
    54  policy  issued,  delivered,  renewed,  and/or  modified  on or after the
    55  effective date of this act.
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