- Summary
- Actions
- Committee Votes
- Floor Votes
- Memo
- Text
- LFIN
- Chamber Video/Transcript
A11043 Summary:
BILL NO | A11043 |
  | |
SAME AS | SAME AS S08924 |
  | |
SPONSOR | Rules (Stern) |
  | |
COSPNSR | Miller ML, Walsh, Espinal |
  | |
MLTSPNSR | |
  | |
Amd §§3216, 3221 & 4303, Ins L | |
  | |
Relates to insurance coverage for enteral formula; includes additional diseases and disorders for which enteral formula has been proven effective. |
A11043 Actions:
BILL NO | A11043 | |||||||||||||||||||||||||||||||||||||||||||||||||
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05/31/2018 | referred to insurance | |||||||||||||||||||||||||||||||||||||||||||||||||
06/06/2018 | reported referred to codes | |||||||||||||||||||||||||||||||||||||||||||||||||
06/11/2018 | reported referred to rules | |||||||||||||||||||||||||||||||||||||||||||||||||
06/13/2018 | reported | |||||||||||||||||||||||||||||||||||||||||||||||||
06/13/2018 | rules report cal.206 | |||||||||||||||||||||||||||||||||||||||||||||||||
06/13/2018 | ordered to third reading rules cal.206 | |||||||||||||||||||||||||||||||||||||||||||||||||
06/18/2018 | passed assembly | |||||||||||||||||||||||||||||||||||||||||||||||||
06/18/2018 | delivered to senate | |||||||||||||||||||||||||||||||||||||||||||||||||
06/18/2018 | REFERRED TO RULES | |||||||||||||||||||||||||||||||||||||||||||||||||
06/20/2018 | SUBSTITUTED FOR S8924 | |||||||||||||||||||||||||||||||||||||||||||||||||
06/20/2018 | 3RD READING CAL.2073 | |||||||||||||||||||||||||||||||||||||||||||||||||
06/20/2018 | PASSED SENATE | |||||||||||||||||||||||||||||||||||||||||||||||||
06/20/2018 | RETURNED TO ASSEMBLY | |||||||||||||||||||||||||||||||||||||||||||||||||
12/17/2018 | delivered to governor | |||||||||||||||||||||||||||||||||||||||||||||||||
12/28/2018 | signed chap.469 |
A11043 Committee Votes:
Cahill | Aye | Barclay | Aye | ||||||
Cook | Aye | Butler | Aye | ||||||
Pretlow | Excused | Hawley | Nay | ||||||
Rivera | Aye | Blankenbush | Aye | ||||||
Cymbrowitz | Aye | Curran | Aye | ||||||
Lavine | Aye | Walter | Aye | ||||||
Hevesi | Aye | Garbarino | Aye | ||||||
Skoufis | Aye | ||||||||
Steck | Aye | ||||||||
Crespo | Aye | ||||||||
Joyner | Aye | ||||||||
Dilan | Aye | ||||||||
Hunter | Aye | ||||||||
Simotas | Aye | ||||||||
Walker | Aye | ||||||||
Niou | Aye | ||||||||
Rosenthal | Aye | ||||||||
Stern | Aye | ||||||||
Lentol | Aye | Curran | Aye | ||||||
Schimminger | Aye | Giglio | Aye | ||||||
Pretlow | Aye | Montesano | Aye | ||||||
Cook | Aye | Morinello | Aye | ||||||
Cymbrowitz | Aye | Palumbo | Aye | ||||||
Titus | Aye | Garbarino | Aye | ||||||
O'Donnell | Excused | ||||||||
Lavine | Aye | ||||||||
Perry | Aye | ||||||||
Zebrowski | Excused | ||||||||
Abinanti | Aye | ||||||||
Weprin | Aye | ||||||||
Mosley | Aye | ||||||||
Hevesi | Aye | ||||||||
Fahy | Aye | ||||||||
Seawright | Aye | ||||||||
Heastie | Aye | Kolb | Aye | ||||||
Gottfried | Aye | Oaks | Aye | ||||||
Lentol | Aye | Butler | Aye | ||||||
Gantt | Excused | Crouch | Aye | ||||||
Nolan | Aye | Finch | Aye | ||||||
Weinstein | Aye | Barclay | Aye | ||||||
Hooper | Excused | Raia | Aye | ||||||
Ortiz | Aye | Hawley | Aye | ||||||
Pretlow | Aye | ||||||||
Cook | Aye | ||||||||
Glick | Aye | ||||||||
Morelle | Aye | ||||||||
Aubry | Aye | ||||||||
Englebright | Aye | ||||||||
Dinowitz | Aye | ||||||||
Colton | Aye | ||||||||
Magnarelli | Aye | ||||||||
Perry | Aye | ||||||||
Galef | Aye | ||||||||
Paulin | Aye | ||||||||
Titus | Aye | ||||||||
Peoples-Stokes | Aye | ||||||||
Benedetto | Aye | ||||||||
Go to top
A11043 Floor Votes:
Yes
Abbate
Yes
Cook
Yes
Garbarino
Yes
Lupardo
Yes
Pellegrino
Yes
Stec
Yes
Abinanti
Yes
Crespo
Yes
Giglio
Yes
Magee
Yes
Peoples-Stokes
Yes
Steck
Yes
Arroyo
Yes
Crouch
Yes
Glick
Yes
Magnarelli
Yes
Perry
Yes
Stern
Yes
Ashby
Yes
Curran
Yes
Goodell
Yes
Malliotakis
Yes
Pheffer Amato
Yes
Stirpe
Yes
Aubry
Yes
Cusick
Yes
Gottfried
Yes
McDonald
Yes
Pichardo
Yes
Tague
Yes
Barclay
Yes
Cymbrowitz
Yes
Gunther
Yes
McDonough
Yes
Pretlow
Yes
Taylor
Yes
Barnwell
ER
Davila
Yes
Hawley
Yes
Mikulin
Yes
Quart
Yes
Thiele
Yes
Barrett
Yes
De La Rosa
Yes
Hevesi
Yes
Miller B
Yes
Ra
Yes
Titone
Yes
Barron
Yes
DenDekker
ER
Hikind
Yes
Miller MG
Yes
Raia
ER
Titus
Yes
Benedetto
Yes
Dickens
Yes
Hooper
Yes
Miller ML
Yes
Ramos
Yes
Vanel
Yes
Bichotte
Yes
Dilan
Yes
Hunter
Yes
Montesano
ER
Richardson
ER
Walker
Yes
Blake
Yes
Dinowitz
Yes
Hyndman
Yes
Morelle
Yes
Rivera
Yes
Wallace
Yes
Blankenbush
Yes
DiPietro
Yes
Jaffee
Yes
Morinello
Yes
Rodriguez
Yes
Walsh
Yes
Bohen
Yes
D'Urso
Yes
Jean-Pierre
Yes
Mosley
Yes
Rosenthal D
Yes
Walter
Yes
Brabenec
Yes
Englebright
Yes
Jenne
Yes
Murray
Yes
Rosenthal L
Yes
Weinstein
Yes
Braunstein
Yes
Epstein
Yes
Johns
Yes
Niou
Yes
Rozic
Yes
Weprin
ER
Brindisi
Yes
Errigo
Yes
Jones
Yes
Nolan
Yes
Ryan
Yes
Williams
Yes
Bronson
Yes
Espinal
Yes
Joyner
Yes
Norris
Yes
Santabarbara
Yes
Woerner
Yes
Buchwald
Yes
Fahy
ER
Kim
Yes
Oaks
Yes
Schimminger
Yes
Wright
Yes
Butler
Yes
Fernandez
Yes
Kolb
Yes
O'Donnell
Yes
Seawright
Yes
Zebrowski
Yes
Byrne
Yes
Finch
Yes
Lalor
Yes
Ortiz
Yes
Simon
Yes
Mr. Speaker
Yes
Cahill
No
Fitzpatrick
ER
Lavine
Yes
Otis
Yes
Simotas
Yes
Carroll
No
Friend
Yes
Lawrence
Yes
Palmesano
Yes
Skoufis
Yes
Castorina
Yes
Galef
Yes
Lentol
Yes
Palumbo
Yes
Smith
Yes
Colton
ER
Gantt
Yes
Lifton
Yes
Paulin
Yes
Solages
‡ Indicates voting via videoconference
A11043 Text:
Go to top STATE OF NEW YORK ________________________________________________________________________ 11043 IN ASSEMBLY May 31, 2018 ___________ Introduced by COMMITTEE ON RULES -- (at request of M. of A. Stern) -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to insurance coverage for enteral formula The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph 21 of subsection (i) of section 3216 of the 2 insurance law, as amended by chapter 388 of the laws of 2013, is amended 3 to read as follows: 4 (21) Every policy which provides coverage for prescription drugs shall 5 include coverage for the cost of enteral formulas for home use, whether 6 administered orally or via tube feeding, for which a physician or other 7 licensed health care provider legally authorized to prescribe under 8 title eight of the education law has issued a written order. Such writ- 9 ten order shall state that the enteral formula is clearly medically 10 necessary and has been proven effective as a disease-specific treatment 11 regimen [for those individuals who are or will become malnourished or12suffer from disorders, which if left untreated, cause chronic physical13disability, mental retardation or death]. Specific diseases and disor- 14 ders for which enteral formulas have been proven effective shall 15 include, but are not limited to, inherited diseases of amino acid or 16 organic acid metabolism; Crohn's Disease; gastroesophageal reflux [with17failure to thrive]; disorders of gastrointestinal motility such as 18 chronic intestinal pseudo-obstruction; and multiple, severe food aller- 19 gies [which if left untreated will cause malnourishment, chronic phys-20ical disability, mental retardation or death] including, but not limited 21 to immunoglobulin E and nonimmunoglobulin E-mediated allergies to multi- 22 ple food proteins; severe food protein induced enterocolitis syndrome; 23 eosinophilic disorders; and impaired absorption of nutrients caused by 24 disorders affecting the absorptive surface, function, length, and motil- 25 ity of the gastrointestinal tract. Enteral formulas which are medically 26 necessary and taken under written order from a physician for the treat- 27 ment of specific diseases shall be distinguished from nutritional 28 supplements taken electively. Coverage for certain inherited diseases of EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD16153-01-8A. 11043 2 1 amino acid and organic acid metabolism as well as severe protein aller- 2 gic conditions shall include modified solid food products that are low 3 protein or which contain modified protein, or are amino acid based which 4 are medically necessary, and such coverage for such modified solid food 5 products for any calendar year or for any continuous period of twelve 6 months for any insured individual shall not exceed two thousand five 7 hundred dollars. 8 § 2. Paragraph 11 of subsection (k) of section 3221 of the insurance 9 law, as amended by chapter 388 of the laws of 2013, is amended to read 10 as follows: 11 (11) Every policy which provides coverage for prescription drugs shall 12 include coverage for the cost of enteral formulas for home use, whether 13 administered orally or via tube feeding, for which a physician or other 14 licensed health care provider legally authorized to prescribe under 15 title eight of the education law has issued a written order. Such writ- 16 ten order shall state that the enteral formula is clearly medically 17 necessary and has been proven effective as a disease-specific treatment 18 regimen [for those individuals who are or will become malnourished or19suffer from disorders, which if left untreated, cause chronic physical20disability, mental retardation or death]. Specific diseases and disor- 21 ders for which enteral formulas have been proven effective shall 22 include, but are not limited to, inherited diseases of amino-acid or 23 organic acid metabolism; Crohn's Disease; gastroesophageal reflux [with24failure to thrive]; disorders of gastrointestinal motility such as 25 chronic intestinal pseudo-obstruction; and multiple, severe food aller- 26 gies [which if left untreated will cause malnourishment, chronic phys-27ical disability, mental retardation or death] including, but not limited 28 to immunoglobulin E and nonimmunoglobulin E-mediated allergies to multi- 29 ple food proteins; severe food protein induced enterocolitis syndrome; 30 eosinophilic disorders and impaired absorption of nutrients caused by 31 disorders affecting the absorptive surface, function, length, and motil- 32 ity of the gastrointestinal tract. Enteral formulas which are medically 33 necessary and taken under written order from a physician for the treat- 34 ment of specific diseases shall be distinguished from nutritional 35 supplements taken electively. Coverage for certain inherited diseases of 36 amino acid and organic acid metabolism as well as severe protein aller- 37 gic conditions shall include modified solid food products that are low 38 protein or which contain modified protein, or are amino acid based which 39 are medically necessary, and such coverage for such modified solid food 40 products for any calendar year or for any continuous period of twelve 41 months for any insured individual shall not exceed two thousand five 42 hundred dollars. 43 § 3. Subsection (y) of section 4303 of the insurance law, as amended 44 by chapter 388 of the laws of 2013, is amended to read as follows: 45 (y) Every contract which provides coverage for prescription drugs 46 shall include coverage for the cost of enteral formulas for home use, 47 whether administered orally or via tube feeding, for which a physician 48 or other licensed health care provider legally authorized to prescribe 49 under title eight of the education law has issued a written order. Such 50 written order shall state that the enteral formula is clearly medically 51 necessary and has been proven effective as a disease-specific treatment 52 regimen [for those individuals who are or will become malnourished or53suffer from disorders, which if left untreated, cause chronic disabili-54ty, mental retardation or death]. Specific diseases and disorders for 55 which enteral formulas have been proven effective shall include, but are 56 not limited to, inherited diseases of amino-acid or organic acid meta-A. 11043 3 1 bolism; Crohn's Disease; gastroesophageal reflux [with failure to2thrive]; disorders of gastrointestinal motility such as chronic intesti- 3 nal pseudo-obstruction; and multiple, severe food allergies [which if4left untreated will cause malnourishment, chronic physical disability,5mental retardation or death] including, but not limited to immunoglobu- 6 lin E and nonimmunoglobulin E-mediated allergies to multiple food prote- 7 ins; severe food protein induced enterocolitis syndrome; eosinophilic 8 disorders; and impaired absorption of nutrients caused by disorders 9 affecting the absorptive surface, function, length, and motility of the 10 gastrointestinal tract. Enteral formulas which are medically necessary 11 and taken under written order from a physician for the treatment of 12 specific diseases shall be distinguished from nutritional supplements 13 taken electively. Coverage for certain inherited diseases of amino acid 14 and organic acid metabolism as well as severe protein allergic condi- 15 tions shall include modified solid food products that are low protein, 16 or which contain modified protein, or are amino acid based which are 17 medically necessary, and such coverage for such modified solid food 18 products for any calendar year or for any continuous period of twelve 19 months for any insured individual shall not exceed two thousand five 20 hundred dollars. 21 § 4. This act shall take effect on the first of January next succeed- 22 ing the date on which it shall have become a law and shall apply to all 23 policies and contracts issued, renewed, modified, altered, or amended on 24 or after such date.