Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L
Requires certain health insurance plans cover electrocardiograms for adults and children who have received a coronavirus vaccine regardless of family history of heart disease or conditions.
STATE OF NEW YORK
________________________________________________________________________
8550
2025-2026 Regular Sessions
IN SENATE
October 24, 2025
___________
Introduced by Sen. WEIK -- read twice and ordered printed, and when
printed to be committed to the Committee on Rules
AN ACT to amend the insurance law and the social services law, in
relation to requiring certain health insurance plans cover electrocar-
diograms for adults and children who have received a coronavirus
vaccine
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Items (iii), (iv) and (v) of subparagraph (E) of paragraph
2 17 of subsection (i) of section 3216 of the insurance law, items (iii)
3 and (iv) as amended by chapter 219 of the laws of 2011 and item (v) as
4 amended by section 3 of part M of chapter 57 of the laws of 2019, are
5 amended and a new item (vi) is added to read as follows:
6 (iii) with respect to children, including infants and adolescents,
7 evidence-informed preventive care and screenings provided for in compre-
8 hensive guidelines supported by the health resources and services admin-
9 istration; [and]
10 (iv) with respect to women, such additional preventive care and
11 screenings not described in item (i) of this subparagraph and as
12 provided for in comprehensive guidelines supported by the health
13 resources and services administration[.];
14 (v) all FDA-approved contraceptive drugs, devices, and other products,
15 including all over-the-counter contraceptive drugs, devices, and
16 products as prescribed or as otherwise authorized under state or federal
17 law; voluntary sterilization procedures pursuant to 42 U.S.C. 18022 and
18 identified in the comprehensive guidelines supported by the health
19 resources and services administration and thereby incorporated in the
20 essential health benefits benchmark plan; patient education and coun-
21 seling on contraception; and follow-up services related to the drugs,
22 devices, products, and procedures covered under this [clause] item,
23 including, but not limited to, management of side effects, counseling
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD13556-02-5
S. 8550 2
1 for continued adherence, and device insertion and removal. Except as
2 otherwise authorized under this [clause] item, a contract shall not
3 impose any restrictions or delays on the coverage required under this
4 [clause] item. However, where the FDA has approved one or more therapeu-
5 tic and pharmaceutical equivalent, as defined by the FDA, versions of a
6 contraceptive drug, device, or product, a contract is not required to
7 include all such therapeutic and pharmaceutical equivalent versions in
8 its formulary, so long as at least one is included and covered without
9 cost-sharing and in accordance with this [clause] item. If the covered
10 therapeutic and pharmaceutical equivalent versions of a drug, device, or
11 product are not available or are deemed medically inadvisable a contract
12 shall provide coverage for an alternate therapeutic and pharmaceutical
13 equivalent version of the contraceptive drug, device, or product without
14 cost-sharing. (a) This coverage shall include emergency contraception
15 without cost sharing when provided pursuant to a prescription, or order
16 under section sixty-eight hundred thirty-one of the education law or
17 when lawfully provided over-the-counter. (b) If the attending health
18 care provider, in [his or her] such provider's reasonable professional
19 judgment, determines that the use of a non-covered therapeutic or phar-
20 maceutical equivalent of a drug, device, or product is warranted, the
21 health care provider's determination shall be final. The superintendent
22 shall promulgate regulations establishing a process, including time-
23 frames, for an insured, an insured's designee or an insured's health
24 care provider to request coverage of a non-covered contraceptive drug,
25 device, or product. Such regulations shall include a requirement that
26 insurers use an exception form that shall meet criteria established by
27 the superintendent. (c) This coverage must allow for the dispensing of
28 up to twelve months worth of a contraceptive at one time. (d) For the
29 purposes of this [clause] item, "over-the-counter contraceptive
30 products" shall mean those products provided for in comprehensive guide-
31 lines supported by the health resources and services administration as
32 of January twenty-first, two thousand nineteen[.]; and
33 (vi) with respect to adults and children who have received a coronavi-
34 rus vaccine, an electrocardiogram test and an interpretation of the
35 results of such test, regardless of whether such adults and children
36 have a family history of heart disease or conditions, if ordered by a
37 physician or other licensed professional whose scope of practice under
38 title eight of the education law provides the authority to administer
39 such a test, in accordance with prevailing clinical standards.
40 § 2. Items (iii) and (iv) of subparagraph (E) of paragraph 8 of
41 subsection (l) of section 3221 of the insurance law, as amended by chap-
42 ter 219 of the laws of 2011, are amended and a new item (v) is added to
43 read as follows:
44 (iii) with respect to children, including infants and adolescents,
45 evidence-informed preventive care and screenings provided for in compre-
46 hensive guidelines supported by the health resources and services admin-
47 istration; [and]
48 (iv) with respect to women, such additional preventive care and
49 screenings not described in item (i) of this subparagraph and as
50 provided for in comprehensive guidelines supported by the health
51 resources and services administration[.]; and
52 (v) with respect to adults and children who have received a coronavi-
53 rus vaccine, an electrocardiogram test and an interpretation of the
54 results of such test, regardless of whether such adults and children
55 have a family history of heart disease or conditions, if ordered by a
56 physician or other licensed professional whose scope of practice under
S. 8550 3
1 title eight of the education law provides the authority to administer
2 such a test, in accordance with prevailing clinical standards.
3 § 3. Subparagraphs (C) and (D) of paragraph 3 of subsection (j) of
4 section 4303 of the insurance law, as added by chapter 219 of the laws
5 of 2011, are amended and a new subparagraph (E) is added to read as
6 follows:
7 (C) with respect to children, including infants and adolescents,
8 evidence-informed preventive care and screenings provided for in compre-
9 hensive guidelines supported by the health resources and services admin-
10 istration; [and]
11 (D) with respect to women, such additional preventive care and screen-
12 ings not described in subparagraph (A) of this paragraph and as provided
13 for in comprehensive guidelines supported by the health resources and
14 services administration[.]; and
15 (E) with respect to adults and children who have received a coronavi-
16 rus vaccine, an electrocardiogram test and an interpretation of the
17 results of such test, regardless of whether such adults and children
18 have a family history of heart disease or conditions, if ordered by a
19 physician or other licensed professional whose scope of practice under
20 title eight of the education law provides the authority to administer
21 such a test, in accordance with prevailing clinical standards.
22 § 4. Subdivision 2 of section 365-a of the social services law is
23 amended by adding a new paragraph (t-1) to read as follows:
24 (t-1) with respect to adults and children who have received a corona-
25 virus vaccine, an electrocardiogram test and an interpretation of the
26 results of such test, regardless of whether such adults and children
27 have a family history of heart disease or conditions, if ordered by a
28 physician or other licensed professional whose scope of practice under
29 title eight of the education law provides the authority to administer
30 such a test, in accordance with prevailing clinical standards; provided,
31 however, that the provisions of this paragraph relating to electrocardi-
32 ogram tests shall not take effect unless all necessary approvals under
33 federal law and regulation have been obtained to receive federal finan-
34 cial participation in the costs of such services.
35 § 5. This act shall take effect immediately and shall apply to any
36 policy issued, delivered, renewed, and/or modified on or after the
37 effective date of this act.
