Requires policies providing prescription drug coverage to cover vitamins and supplements, medical foods, and other medications to mitigate and/or treat the symptoms of mitochondrial disease.
STATE OF NEW YORK
________________________________________________________________________
5174--B
2015-2016 Regular Sessions
IN ASSEMBLY
February 12, 2015
___________
Introduced by M. of A. McDONALD, PICHARDO, DUPREY, WALTER, CRESPO,
CLARK, GOTTFRIED, RUSSELL, DiPIETRO, FAHY, STEC -- Multi-Sponsored by
-- M. of A. BARRON, CERETTO, GALEF, KEARNS, LUPINACCI, McLAUGHLIN --
read once and referred to the Committee on Insurance -- committee
discharged, bill amended, ordered reprinted as amended and recommitted
to said committee -- 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 commit-
tee
AN ACT to amend the insurance law, in relation to requiring prescription
drug coverage to include such supplements and vitamins, medical foods,
and other medications as shall be deemed necessary to mitigate and/or
treat the symptoms of mitochondrial disease
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 33 to read as follows:
3 (33) (A) Every policy which provides coverage for prescription drugs
4 shall include coverage for the cost of such supplements and vitamins,
5 medical foods such as coenzyme Q10, and other medications used to treat
6 the symptoms associated with mitochondrial disease as a physician shall
7 deem necessary to mitigate and/or treat the symptoms of mitochondrial
8 disease diagnosed, through clinical assessment, muscle biopsy, biochemi-
9 cal testing or genetic testing, in a covered person.
10 (B) Such coverage may be subject to such annual deductibles and coin-
11 surance as may be deemed appropriate by the superintendent and as are
12 consistent with those established for other benefits within the policy.
13 § 2. Subsection (k) of section 3221 of the insurance law is amended by
14 adding a new paragraph 21 to read as follows:
15 (21)(A) Every group or blanket policy which provides coverage for
16 prescription drugs shall include coverage for the cost of such supple-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07746-05-6
A. 5174--B 2
1 ments and vitamins, medical foods such as coenzyme Q10, and other medi-
2 cations used to treat the symptoms associated with mitochondrial disease
3 as a physician shall deem necessary to mitigate and/or treat the symp-
4 toms of mitochondrial disease diagnosed, through clinical assessment,
5 muscle biopsy, biochemical testing or genetic testing, in a covered
6 person.
7 (B) Such coverage may be subject to such annual deductibles and coin-
8 surance as may be deemed appropriate by the superintendent and as are
9 consistent with those established for other benefits within the policy.
10 § 3. Section 4303 of the insurance law is amended by adding a new
11 subsection (oo) to read as follows:
12 (oo) (1) Every contract issued by a corporation subject to the
13 provisions of this article which provides coverage for prescription
14 drugs shall include coverage for the cost of such supplements and vita-
15 mins, medical foods such as coenzyme Q10, and other medications used to
16 treat the symptoms associated with mitochondrial disease as a physician
17 shall deem necessary to mitigate and/or treat the symptoms of mitochon-
18 drial disease diagnosed, through clinical assessment, muscle biopsy,
19 biochemical testing or genetic testing, in a covered person.
20 (2) Such coverage may be subject to such annual deductibles and coin-
21 surance as may be deemed appropriate by the superintendent and as are
22 consistent with those established for other benefits within the
23 contract.
24 § 4. This act shall take effect on the first of January next succeed-
25 ing the date on which it shall have become a law and shall apply to
26 policies and contracts issued, reissued, renewed, modified or amended on
27 or after such date.
