STATE OF NEW YORK
________________________________________________________________________
7790--A
2023-2024 Regular Sessions
IN ASSEMBLY
June 15, 2023
___________
Introduced by M. of A. SOLAGES, BICHOTTE HERMELYN -- read once and
referred to the Committee on Insurance -- recommitted to the Committee
on Insurance in accordance with Assembly Rule 3, sec. 2 -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee
AN ACT to amend the insurance law, in relation to expanding coverage
requirements for human donor milk
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph 38 of subsection (i) of section 3216 of the
2 insurance law, as added by section 10 of part MM of chapter 57 of the
3 laws of 2018 and as renumbered by chapter 739 of the laws of 2022, is
4 amended to read as follows:
5 (38) Every policy that provides coverage for hospital, surgical or
6 medical care shall provide the following coverage for pasteurized donor
7 human milk (PDHM), which may include fortifiers as medically indicated[,
8 for inpatient use], for which a licensed medical practitioner has issued
9 an order for an infant who is medically or physically unable to receive
10 maternal breast milk or participate in breast feeding or whose mother is
11 medically or physically unable to produce maternal breast milk at all or
12 in sufficient quantities or participate in breast feeding despite opti-
13 mal lactation support. Such infant shall: (i) have a documented birth
14 weight of less than one thousand five hundred grams; or (ii) have a
15 congenital or acquired condition that places the infant at a high risk
16 for development of necrotizing enterocolitis.
17 § 2. Paragraph 20 of subsection (l) of section 3221 of the insurance
18 law, as added by section 11 of part MM of chapter 57 of the laws of
19 2018, is amended to read as follows:
20 (20) Every insurer delivering a group or blanket policy or issuing a
21 group or blanket policy for delivery in this state that provides cover-
22 age for hospital, surgical or medical care shall provide the following
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD11129-03-4
A. 7790--A 2
1 coverage for pasteurized donor human milk (PDHM), which may include
2 fortifiers as medically indicated[, for inpatient use], for which a
3 licensed medical practitioner has issued an order for an infant who is
4 medically or physically unable to receive maternal breast milk or
5 participate in breast feeding or whose mother is medically or physically
6 unable to produce maternal breast milk at all or in sufficient quanti-
7 ties or participate in breast feeding despite optimal lactation support.
8 Such infant shall: (i) have a documented birth weight of less than one
9 thousand five hundred grams; or (ii) have a congenital or acquired
10 condition that places the infant at a high risk for development of
11 necrotizing enterocolitis.
12 § 3. Subsection (oo) of section 4303 of the insurance law, as added by
13 section 12 of part MM of chapter 57 of the laws of 2018, is amended to
14 read as follows:
15 (oo) A medical expense indemnity corporation, a hospital service
16 corporation or a health service corporation that provides coverage for
17 hospital, surgical or medical care shall provide the following coverage
18 for pasteurized donor human milk (PDHM), which may include fortifiers as
19 medically indicated[, for inpatient use], for which a licensed medical
20 practitioner has issued an order for an infant who is medically or phys-
21 ically unable to receive maternal breast milk or participate in breast
22 feeding or whose mother is medically or physically unable to produce
23 maternal breast milk at all or in sufficient quantities or participate
24 in breast feeding despite optimal lactation support. Such infant shall:
25 (i) have a documented birth weight of less than one thousand five
26 hundred grams; or (ii) have a congenital or acquired condition that
27 places the infant at a high risk for development of necrotizing entero-
28 colitis.
29 § 4. This act shall take effect on the first of January next succeed-
30 ing the date on which it shall have become a law and shall apply to all
31 policies issued, renewed, modified, altered or amended on or after such
32 date. Effectively immediately, the addition, amendment and/or repeal of
33 any rule or regulation necessary for the implementation of this act on
34 its effective date are authorized to be made and completed on or before
35 such date.
