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S10465 Summary:

BILL NOS10465
 
SAME ASNo Same As
 
SPONSORBOTTCHER
 
COSPNSRWEBB
 
MLTSPNSR
 
Amd §§3216, 3221 & 4303, Ins L
 
Relates to gender indication on insurance claim forms; provides policies shall not exclude coverage if gender indication is different from sex assigned at birth or gender otherwise recorded.
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S10465 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          10465
 
                    IN SENATE
 
                                      May 15, 2026
                                       ___________
 
        Introduced  by  Sens.  BOTTCHER, WEBB -- read twice and ordered printed,
          and when printed to be committed to the Committee on Insurance
 
        AN ACT to amend the insurance law, in relation to prohibiting the exclu-
          sion of coverage based upon gender indication on claim forms
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:

     1    Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
     2  amended by adding a new paragraph 42 to read as follows:
     3    (42) Every policy that provides coverage  for  hospital,  surgical  or
     4  medical  care  shall  not  exclude coverage for screening, diagnosis and
     5  treatment of medical conditions, or services otherwise  covered  by  the
     6  policy  solely  on the basis of the gender indicated on a claim form, or
     7  that the gender  indicated  on  a  claim  form  is  different  from  the
     8  insured's  sex  assigned  at birth or gender otherwise recorded, or that
     9  the insured is not of the gender to whom a service is provided.  Nothing
    10  herein  shall  limit  the  insurer's  ability  to take reasonable steps,
    11  including requesting additional information, to  determine  whether  the
    12  insured  is eligible for the services, to review the claim for potential
    13  fraud, or to review the claim for clinical appropriateness.
    14    § 2. Subsection (l) of section 3221 of the insurance law is amended by
    15  adding a new paragraph 24 to read as follows:
    16    (24) Every policy that provides coverage  for  hospital,  surgical  or
    17  medical  care  shall  not  exclude coverage for screening, diagnosis and
    18  treatment of medical conditions, or services otherwise  covered  by  the
    19  policy  solely  on the basis of the gender indicated on a claim form, or
    20  that the gender  indicated  on  a  claim  form  is  different  from  the
    21  insured's  sex  assigned  at birth or gender otherwise recorded, or that
    22  the insured is not of the gender to whom a service is provided.  Nothing
    23  herein  shall  limit  the  insurer's  ability  to take reasonable steps,
    24  including requesting additional information, to  determine  whether  the
    25  insured  is eligible for the services, to review the claim for potential
    26  fraud, or to review the claim for clinical appropriateness.
    27    § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
    28  subsection (yy) to read as follows:
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD07854-03-6

        S. 10465                            2
 
     1    (yy)  Every  contract that provides coverage for hospital, surgical or
     2  medical care shall not exclude coverage  for  screening,  diagnosis  and
     3  treatment  of  medical  conditions, or services otherwise covered by the
     4  contract solely on the basis of the gender indicated on a claim form, or
     5  that  the  gender  indicated  on  a  claim  form  is  different from the
     6  insured's sex assigned at birth or gender otherwise  recorded,  or  that
     7  the  insured is not of the gender to whom a service is provided. Nothing
     8  herein shall limit the  insurer's  ability  to  take  reasonable  steps,
     9  including  requesting  additional  information, to determine whether the
    10  insured is eligible for the services, to review the claim for  potential
    11  fraud, or to review the claim for clinical appropriateness.
    12    §  4. This act shall take effect on the first of January next succeed-
    13  ing the date on which it shall have become a  law  and  shall  apply  to
    14  policies  and contracts issued, renewed, modified, altered or amended on
    15  or after such effective date.
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