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A09140 Summary:

BILL NOA09140
 
SAME ASSAME AS S08348
 
SPONSORSolages
 
COSPNSR
 
MLTSPNSR
 
Add §2500-l, Pub Health L; amd §§3216, 3221 & 4303, Ins L
 
Relates to universal newborn nurse home visiting services; requires health insurance coverage for universal newborn nurse home visiting services; authorizes the department of health to apply for certain waivers; directs the superintendent of financial services to require an insurer, health carrier or health benefit plan to notify enrollees annually of universal newborn nurse home visiting services.
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A09140 Actions:

BILL NOA09140
 
01/31/2022referred to insurance
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A09140 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A9140
 
SPONSOR: Solages
  TITLE OF BILL: An act to amend the public health law, in relation to universal newborn nurse home visiting services; to amend the insurance law, in relation to requiring health insurance coverage for universal newborn nurse home visiting services; authorizing the department of health to apply for certain waivers; and directing the superintendent of financial services to require an insurer, health carrier or health benefit plan to notify enrollees annually of universal newborn nurse home visiting services   PURPOSE OR GENERAL IDEA OF BILL: This bill extends access to free newborn nurse home visiting services, as well as maternal education, to every mother, regardless of socioeco- nomic status, race, or ethnicity which will work to dismantle the gener- ational damage done by an inequitable health care system.   SUMMARY OF SPECIFIC PROVISIONS: Section 1 adds section § 2500-1 to public health law requiring the commissioner to design, implement, and maintain a voluntary, evidence- based, state-wide program to provide universal newborn nurse home visit- ing services to all families within the state. Section 2 amends subsection (1) of section 3216 of the insurance law adding a new paragraph 36 requiring that every hospital, surgical or medical coverage provide coverage for a voluntary, evidence-based universal newborn nurse home visiting service at no cost and inform each individual covered of this service when a newborn is added under the plan. Section 3 amends subsection (k) of section 3221 of the insurance law adding a new paragraph 22 requiring that every group or blanket policy delivered or issued for delivery providing hospital, surgical, or medical coverage provide coverage for a voluntary, evidence-based universal newborn nurse home visiting service at no cost and inform each individual covered of this service when a newborn is added under the plan. Section 4 amends section 4303 of the insurance law adding a subsection (ss)requiring that any medical expense indemnity corporation, hospital service corporation or health service corporation providing hospital, surgical, or medical coverage provide coverage for a voluntary, evidence-based universal newborn nurse home visiting service at no cost and inform each individual covered of this service when a newborn is added under the plan. Section 5 authorizes the department of health to request a waiver for state innovation for costs accrued under sections two, three and four of this act. Section 6 requires an annual notification to insurance enrollees of the plan's provision of the universal newborn nurse home visiting services to be delivered by mail or other agreed upon method, giving authori- zation of implementation of notifications to the superintendent of financial services.   JUSTIFICATION: This bill will positively affect families and communities historically impacted by systemically inequitable medical practices and economic conditions. Targeting New York's most marginalized, this bill will close the racial and economic care-gap that has led to higher rates of mater- nal and infant mortality. Poverty, poor mental and physical health, high juvenile crime rates, adverse childhood experiences, and poor academic performance are prevalent within disadvantaged communities due to systemic inequities built into policy, such as unequal access to health- care and education. This bill extends access to free newborn nurse home visiting services, as well as maternal education, to every mother, regardless of socioeconomic status, race, or ethnicity which will work to dismantle the generational damage done by an inequitable health care system. Newborn nurse home visiting services are not readily available to all enrolled persons covered by insurance. This service is aimed at improv- ing outcomes in one or more of the following: child health and develop- ment, school readiness, family financial self-sufficiency, maternal health, positive parenting, reducing adverse childhood experiences, reducing family violence, and reducing crime. This will be achieved through education, promotion of positive interaction between mother and newborn to influence growth and development, and offering other guidance to mothers that otherwise would be difficult to afford.   PRIOR LEGISLATIVE HISTORY: New Bill.   FISCAL IMPLICATIONS: TBD.   EFFECTIVE DATE: This act shall take effect on the ninetieth day after it shall have become a law and shall apply to any policy issued, delivered, renewed, and/or modified on or after the effective date of this act. Effective immediately, the addition, amendment and/or repeal of any rule or regu- lation necessary for the implementation of this act on its effective date are authorized to be made and completed on or before such effective date.
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A09140 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          9140
 
                   IN ASSEMBLY
 
                                    January 31, 2022
                                       ___________
 
        Introduced  by M. of A. SOLAGES -- read once and referred to the Commit-
          tee on Insurance
 
        AN ACT to amend the public health law, in relation to universal  newborn
          nurse  home visiting services; to amend the insurance law, in relation
          to requiring health insurance coverage  for  universal  newborn  nurse
          home  visiting services; authorizing the department of health to apply
          for certain waivers; and directing  the  superintendent  of  financial
          services  to require an insurer, health carrier or health benefit plan
          to notify enrollees annually of universal newborn nurse home  visiting
          services
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. The public health law is amended by adding a new section to
     2  read as follows:
     3    § 2500-l.  Universal newborn nurse home visiting services. 1. As  used
     4  in this section, "community" means a geographic region, county, tribe or
     5  other group of individuals living in proximity as defined by the depart-
     6  ment by rule.
     7    2.  (a) The commissioner shall design, implement and maintain a volun-
     8  tary statewide program to provide universal newborn nurse home  visiting
     9  services to all families with newborns residing in this state to support
    10  healthy  child  development  and  strengthen  families. The commissioner
    11  shall design the universal newborn nurse home  visiting  program  to  be
    12  flexible  so  as  to meet the needs of the communities where the program
    13  operates.
    14    (b) In designing the program described in paragraph (a) of this subdi-
    15  vision, the commissioner shall consult, coordinate and  collaborate,  as
    16  necessary,  with insurers that offer health benefit plans in this state,
    17  hospitals, local  public  health  authorities,  the  early  intervention
    18  program,  existing  early  childhood  home visiting programs, community-
    19  based organizations and social service providers.
    20    3. The program shall provide nurse home visiting services that are:
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14370-01-2

        A. 9140                             2
 
     1    (a) based on criteria established by the United States  Department  of
     2  Health  and  Human  Services  for an evidence-based early childhood home
     3  visiting service delivery model;
     4    (b)  provided  by registered nurses licensed in this state to families
     5  caring for newborns up to the age of six months,  including  foster  and
     6  adoptive newborns;
     7    (c) provided in the family's home; and
     8    (d)  aimed  at  improving  outcomes  in  one  or more of the following
     9  domains:
    10    (i) child health;
    11    (ii) child development and school readiness;
    12    (iii) family economic self-sufficiency;
    13    (iv) maternal health;
    14    (v) positive parenting;
    15    (vi) reducing child mistreatment;
    16    (vii) reducing juvenile delinquency;
    17    (viii) reducing family violence; or
    18    (ix) reducing crime.
    19    4. The services provided in the program must:
    20    (a) be voluntary and carry no negative consequences for a family  that
    21  declines to participate;
    22    (b) be offered in every community in this state;
    23    (c)  include  an evidence-based assessment of the physical, social and
    24  emotional factors affecting the family;
    25    (d) be offered to all families with newborns residing in the community
    26  where the program operates;
    27    (e) include at least one visit during a newborn's first  three  months
    28  of  life with the opportunity for the family to choose up to three addi-
    29  tional visits;
    30    (f) include a follow-up visit no later than  three  months  after  the
    31  last visit; and
    32    (g) provide information and referrals to address each family's identi-
    33  fied needs.
    34    5.  The  authority  shall  collect  and  analyze data generated by the
    35  program to assess the effectiveness of the program in meeting  the  aims
    36  described  in  paragraph  (d)  of  subdivision three of this section and
    37  shall work with other state agencies to develop  protocols  for  sharing
    38  data,  including  the timely sharing of data with primary care providers
    39  of care to the families with newborns receiving the services.
    40    6.   The  commissioner  shall  adopt  by  rule,  consistent  with  the
    41  provisions  of  this  section, criteria for universal newborn nurse home
    42  visiting services that must be covered by health benefit plans.
    43    § 2. Subsection (i) of section 3216 of the insurance law is amended by
    44  adding a new paragraph 36 to read as follows:
    45    (36)(A) Every policy which  provides  hospital,  surgical  or  medical
    46  coverage  shall provide coverage for universal newborn nurse home visit-
    47  ing services as prescribed by the department of  health  by  rule  under
    48  section  twenty-five  hundred-l  of the public health law.  The coverage
    49  must be provided without any  cost-sharing,  coinsurance  or  deductible
    50  applicable to the services.
    51    (B) Insurers must offer universal newborn nurse home visiting services
    52  in  their health benefit plans but an individual enrolled in the plan is
    53  not required to receive the services as a condition of coverage and  may
    54  not be penalized or in any way discouraged from declining the services.

        A. 9140                             3
 
     1    (C)  An  insurer  must notify an individual enrolled in the plan about
     2  the universal newborn nurse home visiting services whenever  such  indi-
     3  vidual adds a newborn to coverage under the plan.
     4    (D) An insurer may use in-network providers or may contract with local
     5  public health authorities to provide the services.
     6    (E)  This  paragraph does not require an insurer to reimburse the cost
     7  of the services in any specific manner. The services may  be  reimbursed
     8  using:
     9    (i) a value-based payment methodology;
    10    (ii) a claim invoicing process;
    11    (iii) capitated payments;
    12    (iv)  a  payment  methodology  that  takes into account the need for a
    13  community-based entity providing the services to expand its capacity  to
    14  provide the services and address health disparities; or
    15    (v) any other methodology agreed to by the insurer and the provider of
    16  the services.
    17    (F)  Insurers  shall report to the department of public health, in the
    18  form and manner prescribed by the  department  of  public  health,  data
    19  regarding  claims submitted for services covered under this paragraph to
    20  monitor the provision of  the  universal  newborn  nurse  home  visiting
    21  services.
    22    § 3. Subsection (k) of section 3221 of the insurance law is amended by
    23  adding a new paragraph 22 to read as follows:
    24    (22)(A)  Every group  or blanket policy delivered or issued for deliv-
    25  ery in this state which   provides   hospital,   surgical   or   medical
    26  coverage  shall include coverage for universal newborn nurse home visit-
    27  ing services as prescribed by the department of  health  by  rule  under
    28  section  twenty-five  hundred-l  of the public health law.  The coverage
    29  must be provided without any  cost-sharing,  coinsurance  or  deductible
    30  applicable to the services.
    31    (B) Insurers must offer universal newborn nurse home visiting services
    32  in  their health benefit plans but an individual enrolled in the plan is
    33  not required to receive the services as a condition of coverage and  may
    34  not be penalized or in any way discouraged from declining the services.
    35    (C)  An  insurer  must notify an individual enrolled in the plan about
    36  the universal newborn nurse home visiting services whenever  such  indi-
    37  vidual adds a newborn to coverage under the plan.
    38    (D) An insurer may use in-network providers or may contract with local
    39  public health authorities to provide the services.
    40    (E)  This  paragraph does not require an insurer to reimburse the cost
    41  of the services in any specific manner. The services may  be  reimbursed
    42  using:
    43    (i) a value-based payment methodology;
    44    (ii) a claim invoicing process;
    45    (iii) capitated payments;
    46    (iv)  a  payment  methodology  that  takes into account the need for a
    47  community-based entity providing the services to expand its capacity  to
    48  provide the services and address health disparities; or
    49    (v) any other methodology agreed to by the insurer and the provider of
    50  the services.
    51    (F)  Insurers  shall report to the department of public health, in the
    52  form and manner prescribed by the  department  of  public  health,  data
    53  regarding  claims submitted for services covered under this paragraph to
    54  monitor the provision of  the  universal  newborn  nurse  home  visiting
    55  services.

        A. 9140                             4
 
     1    §  4.  Section  4303  of  the insurance law is amended by adding a new
     2  subsection (ss) to read as follows:
     3    (ss)(1) A medical  expense  indemnity  corporation, a hospital service
     4  corporation or a health service corporation that provides  coverage  for
     5  hospital,  surgical or medical care shall include coverage for universal
     6  newborn nurse home visiting services as prescribed by the department  of
     7  health  by rule under section twenty-five hundred-l of the public health
     8  law. The coverage must be provided without any cost-sharing, coinsurance
     9  or deductible applicable to the services.
    10    (2) Insurers must offer universal newborn nurse home visiting services
    11  in their health benefit plans but an individual enrolled in the plan  is
    12  not  required to receive the services as a condition of coverage and may
    13  not be penalized or in any way discouraged from declining the services.
    14    (3) An insurer must notify an individual enrolled in  the  plan  about
    15  the  universal  newborn nurse home visiting services whenever such indi-
    16  vidual adds a newborn to coverage under the plan.
    17    (4) An insurer may use in-network providers or may contract with local
    18  public health authorities to provide the services.
    19    (5) This paragraph does not require an insurer to reimburse  the  cost
    20  of  the  services in any specific manner. The services may be reimbursed
    21  using:
    22    (A) a value-based payment methodology;
    23    (B) a claim invoicing process;
    24    (C) capitated payments;
    25    (D) a payment methodology that takes  into  account  the  need  for  a
    26  community-based  entity providing the services to expand its capacity to
    27  provide the services and address health disparities; or
    28    (E) any other methodology agreed to by the insurer and the provider of
    29  the services.
    30    (6) Insurers shall report to the department of public health,  in  the
    31  form  and  manner  prescribed  by  the department of public health, data
    32  regarding claims submitted for services covered under this paragraph  to
    33  monitor  the  provision  of  the  universal  newborn nurse home visiting
    34  services.
    35    § 5. The department of health may request a  waiver  for  state  inno-
    36  vation  under  42 U.S.C. 18052 to obtain federal financial participation
    37  in the cost of services provided under sections two, three and  four  of
    38  this act.
    39    §  6. The superintendent of financial services shall require an insur-
    40  er, health carrier or health benefit plan to notify  enrollees  annually
    41  of universal newborn nurse home visiting services covered by such enrol-
    42  lees'  health benefit plan. The notice shall be delivered by mail unless
    43  the enrollee and health carrier have agreed on another method of notifi-
    44  cation. The  superintendent  of  financial  services  is  authorized  to
    45  promulgate necessary rules and regulations for the purposes of providing
    46  such notification.
    47    §  7.  This  act shall take effect on the ninetieth day after it shall
    48  have become a law and shall  apply  to  any  policy  issued,  delivered,
    49  renewed,  and/or  modified  on  or after the effective date of this act.
    50  Effective immediately, the addition, amendment and/or repeal of any rule
    51  or regulation necessary for the implementation of this act on its effec-
    52  tive date are authorized to be made and  completed  on  or  before  such
    53  effective date.
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