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A05140 Summary:

BILL NOA05140
 
SAME ASSAME AS S06494
 
SPONSORSolages
 
COSPNSRGonzalez-Rojas, Woerner, Taylor, Meeks, Cunningham
 
MLTSPNSR
 
Amd §§3216, 3221 & 4303, Ins L
 
Requires health insurance policies to include coverage for doula services as required coverage for maternity care.
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A05140 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          5140
 
                               2025-2026 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 12, 2025
                                       ___________
 
        Introduced by M. of A. SOLAGES, GONZALEZ-ROJAS, WOERNER -- read once and
          referred to the Committee on Insurance
 
        AN  ACT  to  amend  the  insurance  law, in relation to requiring health
          insurance policies to include coverage for doula services as  required
          coverage for maternity care

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Item (i) of subparagraph (A) of paragraph 10 of  subsection
     2  (i)  of  section 3216 of the insurance law, as amended by chapter 238 of
     3  the laws of 2010, is amended to read as follows:
     4    (i) Every policy which provides hospital, surgical or medical coverage
     5  shall provide coverage for maternity care, including hospital,  surgical
     6  or  medical  care  to the same extent that hospital, surgical or medical
     7  coverage is provided for illness  or  disease  under  the  policy.  Such
     8  maternity  care  coverage,  other  than  coverage  for perinatal compli-
     9  cations, shall include inpatient hospital coverage for  mother  and  for
    10  newborn for at least forty-eight hours after childbirth for any delivery
    11  other  than a caesarean section, and for at least ninety-six hours after
    12  a caesarean section. Such coverage for maternity care shall include  the
    13  services  of  a doula and the services of a midwife licensed pursuant to
    14  article one hundred forty of the education  law,  practicing  consistent
    15  with  section  sixty-nine  hundred  fifty-one  of  the education law and
    16  affiliated or practicing in conjunction with a facility licensed  pursu-
    17  ant  to  article  twenty-eight  of the public health law, but no insurer
    18  shall be required to  pay  for  duplicative  routine  services  actually
    19  provided by both a licensed midwife and a physician.
    20    §  2. Item (i) of subparagraph (A) of paragraph 5 of subsection (k) of
    21  section 3221 of the insurance law, as amended by chapter 238 of the laws
    22  of 2010, is amended to read as follows:
    23    (i) Every group or blanket policy delivered or issued for delivery  in
    24  this  state  which provides hospital, surgical or medical coverage shall
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09185-01-5

        A. 5140                             2
 
     1  include coverage for maternity care,  including  hospital,  surgical  or
     2  medical care to the same extent that coverage is provided for illness or
     3  disease  under  the  policy.  Such  maternity  care coverage, other than
     4  coverage  for  perinatal complications, shall include inpatient hospital
     5  coverage for mother and newborn for at  least  forty-eight  hours  after
     6  childbirth  for  any delivery other than a caesarean section, and for at
     7  least ninety-six hours after a  caesarean  section.  Such  coverage  for
     8  maternity care shall include the services of a doula and the services of
     9  a  midwife  licensed pursuant to article one hundred forty of the educa-
    10  tion law, practicing consistent with section sixty-nine  hundred  fifty-
    11  one  of  the  education  law and affiliated or practicing in conjunction
    12  with a facility licensed pursuant to article twenty-eight of the  public
    13  health  law,  but  no  insurer  shall be required to pay for duplicative
    14  routine services actually provided by both  a  licensed  midwife  and  a
    15  physician.
    16    § 3. Subparagraph (A) of paragraph 1 of subsection (c) of section 4303
    17  of  the insurance law, as amended by chapter 238 of the laws of 2010, is
    18  amended to read as follows:
    19    (A) Every contract issued by a corporation subject to  the  provisions
    20  of  this article which provides hospital service, medical expense indem-
    21  nity or both shall provide coverage for maternity care including  hospi-
    22  tal,  surgical or medical care to the same extent that hospital service,
    23  medical expense indemnity or both are provided for  illness  or  disease
    24  under  the  contract.  Such maternity care coverage, other than coverage
    25  for perinatal complications, shall include inpatient  hospital  coverage
    26  for  mother  and for newborn for at least forty-eight hours after child-
    27  birth for any delivery other than a caesarean section, and for at  least
    28  ninety-six hours following a caesarean section. Such coverage for mater-
    29  nity  care  shall  include the services of a doula and the services of a
    30  midwife licensed pursuant to article one hundred forty of the  education
    31  law,  practicing consistent with section sixty-nine hundred fifty-one of
    32  the education law and affiliated or practicing  in  conjunction  with  a
    33  facility  licensed pursuant to article twenty-eight of the public health
    34  law, but no insurer shall be required to  pay  for  duplicative  routine
    35  services actually provided by both a licensed midwife and a physician.
    36    § 4. This act shall take effect on the one hundred eightieth day after
    37  it shall have become a law and shall apply to all policies and contracts
    38  issued,  renewed,  modified,  altered  or amended on or after such date.
    39  Effective immediately the addition, amendment or repeal of any  rule  or
    40  regulation necessary for the implementation of this act on its effective
    41  date are authorized to be made and completed on or before such date.
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