STATE OF NEW YORK
________________________________________________________________________
10030--B
Cal. No. 325
IN ASSEMBLY
January 30, 2026
___________
Introduced by M. of A. WEPRIN, BERGER -- read once and referred to the
Committee on Insurance -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee -- reported
from committee, advanced to a third reading, amended and ordered
reprinted, retaining its place on the order of third reading
AN ACT to amend the insurance law, in relation to requiring health
insurers to provide coverage for speech therapy for stuttering
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subsection (k) of section 3221 of the insurance law is
2 amended by adding a new paragraph 24 to read as follows:
3 (24) (A) Every large group policy delivered or issued for delivery in
4 this state which provides medical, major medical, or similar comprehen-
5 sive-type coverage shall, upon the referral of a physician, provide
6 coverage for all costs for speech therapy for stuttering. Such speech
7 therapy shall include, but not be limited to, habilitative speech thera-
8 py treatment and rehabilitative speech therapy treatment for stuttering,
9 provided such treatment is performed by a health care professional
10 licensed pursuant to title eight of the education law. Such coverage
11 shall not be subject to any durational benefit limitation or maximum for
12 benefits, services, or visits provided under this paragraph.
13 (B) Nothing in this paragraph shall be construed to prevent the
14 medical management or utilization review of the services or prevent a
15 policy from requiring that services be provided through a network of
16 participating providers.
17 (C) Coverage may be denied on the basis that such treatment is being
18 provided to the insured pursuant to an individualized family service
19 plan under section twenty-five hundred forty-five of the public health
20 law or an individualized education plan under article eighty-nine of the
21 education law. The provision of services pursuant to an individualized
22 family service plan under section twenty-five hundred forty-five of the
23 public health law or an individualized education plan under article
24 eighty-nine of the education law shall not affect coverage under the
25 policy for services provided on a supplemental basis outside of an
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07423-08-6
A. 10030--B 2
1 educational setting if such services are provided upon the referral of a
2 physician.
3 § 2. Section 4303 of the insurance law is amended by adding a new
4 subsection (yy) to read as follows:
5 (yy) (A) Every large group contract issued by a medical expense indem-
6 nity corporation, hospital service corporation and health service corpo-
7 ration which provides medical, major medical, or similar comprehensive-
8 type coverage shall, upon referral of a physician, provide coverage for
9 all costs for speech therapy for stuttering. Such speech therapy shall
10 include, but not be limited to, habilitative speech therapy treatment
11 and rehabilitative speech therapy treatment for stuttering, provided
12 such treatment is performed by a health care professional licensed
13 pursuant to title eight of the education law. Such coverage shall not be
14 subject to any durational benefit limitation or maximum for benefits,
15 services, or visits provided under this subsection.
16 (B) Nothing in this subsection shall be construed to prevent the
17 medical management or utilization review of the services or prevent a
18 policy from requiring that services be provided through a network of
19 participating providers.
20 (C) Coverage may be denied on the basis that such treatment is being
21 provided to the insured pursuant to an individualized family service
22 plan under section twenty-five hundred forty-five of the public health
23 law or an individualized education plan under article eighty-nine of the
24 education law. The provision of services pursuant to an individualized
25 family service plan under section twenty-five hundred forty-five of the
26 public health law or an individualized education plan under article
27 eighty-nine of the education law shall not affect coverage under the
28 policy for services provided on a supplemental basis outside of an
29 educational setting if such services are provided upon the referral of a
30 physician.
31 § 3. This act shall take effect January 1, 2028 and shall apply to
32 policies and contracts issued, renewed, modified, altered or amended on
33 or after such effective date. Effective immediately, the addition,
34 amendment and/or repeal of any rule or regulation necessary for the
35 implementation of this act on its effective date are authorized to be
36 made and completed on or before such effective date.
