Relates to mandatory health insurance coverage for providing prosthetic devices equal to or above Medicare's standard of coverage; includes the repair or replacement of a prosthetic device required to be worn or used by a policy holder; includes expenses for assessment, evaluation, treatment, management, and follow-up care.
STATE OF NEW YORK
________________________________________________________________________
1103--A
2013-2014 Regular Sessions
IN ASSEMBLY(Prefiled)
January 9, 2013
___________
Introduced by M. of A. GUNTHER, ORTIZ, ROSENTHAL, WRIGHT, JAFFEE,
JACOBS, PERRY, CLARK, HOOPER, KELLNER, McKEVITT, DINOWITZ, DUPREY,
BOYLAND, ZEBROWSKI, TITONE, RIVERA, ABINANTI, COLTON, DenDEKKER, RAIA
-- Multi-Sponsored by -- M. of A. ABBATE, BENEDETTO, COOK, CROUCH,
CUSICK, GALEF, GIGLIO, GOTTFRIED, MAGNARELLI, MILLMAN, PAULIN, SCAR-
BOROUGH, SCHIMEL, SKARTADOS, SWEENEY, THIELE, WEISENBERG -- 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 mandatory health
insurance coverage for providing prosthetic devices
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 30 to read as follows:
3 (30) Every policy which provides medical, major medical, or similar
4 comprehensive type coverage shall include coverage equal to or above
5 Medicare's standard of coverage for prosthetic devices. This shall
6 include coverage not only for the provision of a prosthetic device
7 required to be worn or used by a policy holder but also the repair or
8 replacement of a prosthetic device required to be worn or used by a
9 policy holder. Coverage shall include expenses for assessment, evalu-
10 ation, treatment, management, and follow-up care. Coverage shall not be
11 denied on the ground that it is for cosmetic purposes or is not for a
12 functional defect or impairment. The term "prosthetic device" as used in
13 this section includes an artificial limb or artificial eye but shall not
14 include shoes or any other article considered as ordinary wearing
15 apparel, whether or not specially constructed.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02404-03-4
A. 1103--A 2
1 § 2. Subsection (l) of section 3221 of the insurance law is amended by
2 adding a new paragraph 19 to read as follows:
3 (19) Every policy which provides medical, major medical, or similar
4 comprehensive type coverage shall include coverage equal to or above
5 Medicare's standard of coverage for prosthetic devices. This shall
6 include coverage not only for the provision of a prosthetic device
7 required to be worn or used by a policy holder but also the repair or
8 replacement of a prosthetic device required to be worn or used by a
9 policy holder. Coverage shall include expenses for assessment, evalu-
10 ation, treatment, management, and follow-up care. Coverage shall not be
11 denied on the ground that it is for cosmetic purposes or is not for a
12 functional defect or impairment. The term "prosthetic device" as used in
13 this section includes an artificial limb or artificial eye but shall not
14 include shoes or any other article considered as ordinary wearing
15 apparel, whether or not specially constructed.
16 § 3. Section 4303 of the insurance law is amended by adding a new
17 subsection (oo) to read as follows:
18 (oo) Every policy which provides medical, major medical, or similar
19 comprehensive type coverage shall include coverage equal to or above
20 Medicare's standard of coverage for prosthetic devices. This shall
21 include coverage not only for the provision of a prosthetic device
22 required to be worn or used by a policy holder but also the repair or
23 replacement of a prosthetic device required to be worn or used by a
24 policy holder. Coverage shall include expenses for assessment, evalu-
25 ation, treatment, management, and follow-up care. Coverage shall not be
26 denied on the ground that it is for cosmetic purposes or is not for a
27 functional defect or impairment. The term "prosthetic device" as used in
28 this section includes an artificial limb or artificial eye but shall not
29 include shoes or any other article considered as ordinary wearing
30 apparel, whether or not specially constructed.
31 § 4. This act shall take effect on the ninetieth day after it shall
32 have become a law and shall apply to policies and contracts issued,
33 renewed, modified, altered or amended on or after such effective date.
