Relates to the mandatory health insurance coverage under health insurance plans of cleft lip and cleft palate to include treatment of related conditions and illnesses.
STATE OF NEW YORK
________________________________________________________________________
6397--A
2017-2018 Regular Sessions
IN ASSEMBLY
March 6, 2017
___________
Introduced by M. of A. SIMON, MORELLE, McDONOUGH, STEC, M. G. MILLER,
HARRIS, KEARNS, LAVINE, MOSLEY, TITONE, ROSENTHAL, GOTTFRIED,
BICHOTTE, JAFFEE, ZEBROWSKI, GUNTHER, GALEF, JENNE, D'URSO, NIOU,
GRAF, MONTESANO, SEPULVEDA, COOK, HUNTER, CARROLL, McDONALD, GJONAJ,
PALUMBO -- Multi-Sponsored by -- M. of A. BRAUNSTEIN, COLTON, ENGLE-
BRIGHT, GIGLIO, HOOPER, HYNDMAN, LUPARDO -- read once and referred to
the Committee on Insurance -- 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 cleft lip and cleft palate
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 34 to read as follows:
3 (34) Every policy which provides medical, major medical, or similar
4 comprehensive-type coverage shall include coverage for the assessment,
5 evaluation, treatment, management, and follow-up care of cleft lip and
6 cleft palate. Such coverage shall include but not be limited to treat-
7 ment for any condition or illness which is related to or developed as a
8 result of cleft lip and/or palate. Coverage shall not be denied on the
9 ground that it is for cosmetic purposes or is not for a functional
10 defect or impairment.
11 § 2. Subsection (l) of section 3221 of the insurance law is amended by
12 adding a new paragraph 20 to read as follows:
13 (20) Every policy which provides medical, major medical, or similar
14 comprehensive-type coverage shall include coverage for the assessment,
15 evaluation, treatment, management, and follow-up care of cleft lip and
16 cleft palate. Such coverage shall include but not be limited to treat-
17 ment for any condition or illness which is related to or developed as a
18 result of cleft lip and/or palate. Coverage shall not be denied on the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD06145-02-7
A. 6397--A 2
1 ground that it is for cosmetic purposes or is not for a functional
2 defect or impairment.
3 § 3. Section 4303 of the insurance law is amended by adding a new
4 subsection (oo) to read as follows:
5 (oo) Every policy which provides medical, major medical, or similar
6 comprehensive-type coverage shall include coverage for the assessment,
7 evaluation, treatment, management, and follow-up care of cleft lip and
8 cleft palate. Such coverage shall include but not be limited to treat-
9 ment for any condition or illness which is related to or developed as a
10 result of cleft lip and/or palate. Coverage shall not be denied on the
11 ground that it is for cosmetic purposes or is not for a functional
12 defect or impairment.
13 § 4. This act shall take effect on the ninetieth day after it shall
14 have become a law and shall apply to policies and contracts issued,
15 renewed, modified, altered or amended on or after such date.
