•  Summary 
  •  
  •  Actions 
  •  
  •  Committee Votes 
  •  
  •  Floor Votes 
  •  
  •  Memo 
  •  
  •  Text 
  •  
  •  LFIN 
  •  
  •  Chamber Video/Transcript 

A01682 Summary:

BILL NOA01682A
 
SAME ASSAME AS S03234-A
 
SPONSORWoerner (MS)
 
COSPNSRSimon, Dickens, Thiele, Cruz, Gunther, Seawright, Glick, Reyes
 
MLTSPNSRSayegh
 
Amd 3216, 3221 & 4303, Ins L
 
Relates to gender indication on insurance claim forms; provides policies shall not exclude coverage if gender indication is different from sex assigned at birth or gender otherwise recorded.
Go to top    

A01682 Actions:

BILL NOA01682A
 
01/17/2023referred to insurance
05/31/2023amend (t) and recommit to insurance
05/31/2023print number 1682a
01/03/2024referred to insurance
Go to top

A01682 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A1682A
 
SPONSOR: Woerner (MS)
  TITLE OF BILL: An act to amend the insurance law, in relation to prohibiting the exclu- sion of coverage based upon gender indication on claim forms   PURPOSE: The purpose of this bill is to prohibit health insurance claim denials based on the gender of an insured person.   SUMMARY OF PROVISIONS: Section 1: amends subdivision (i) of section 3216 of the insurance law to prohibit individual accident and health insurers from excluding coverage for screening, diagnosis and treatment of medical conditions, or services otherwise covered by the policy solely on the basis of the gender indicated on a claim form, or that the gender indicated on a claim form is different from the insured's sex assigned at birth or gender otherwise recorded, or that the insured is not of the gender to whom a service is typically or exclusively provided. Section 2: amends subsection (1) of section 3221 of the insurance law to prohibit group insurers from excluding coverage for screening, diagnosis and treatment of medical conditions, or services otherwise covered by the policy solely on the basis of the gender indicated on a claim form, or that the gender indicated on a claim form is different from the insured's sex assigned at birth or gender otherwise recorded, or that the insured is not of the gender to whom a service is typically or exclusively provided. Section 3: adds a new subsection (uu) to section 4303 of the insurance law to prohibit group insurers from excluding coverage for screening, diagnosis and treatment of medical conditions, or services otherwise covered by the policy solely on the basis of the gender indicated on a claim form, or that the gender indicated on a claim form is different from the insured's sex assigned at birth or gender otherwise recorded, or that the insured is not of the gender to whom a service is typically or exclusively provided. Section 4: establishes the effective date.   JUSTIFICATION: It has come to light that health insurers have been denying claims of transgender individuals because the gender with which the individual identifies does not match the gender of someone to whom those services are typically provided. Additionally, claims of transgender individuals are being denied solely on the basis that the gender on a claim form does not match the gender on the insurance company's records. This results in individuals having to appeal these denials, many of which are subsequently overturned, before they can receive coverage. This bill addresses these issues and ensures that transgender individ- uals receive health care coverage in a timely manner by prohibiting health insurers from denying coverage solely on the basis of the gender indicated on a claim form, or that the gender on a claim form does not match the insured's gender otherwise recorded, or that the gender with which the individual identifies does not match the gender of someone to whom those services are typically provided.   LEGISLATIVE HISTORY: A.1327 of 2021-22: Referred to Insurance. S.726 of 2021-22: Referred to Insurance. A.6837 of 2020: Referred to Insurance. S.05330 of 2020: Referred to Insurance. A.11031 of 2017-2018: Referred to Insurance.   FISCAL IMPLICATIONS: None.   EFFECTIVE DATE: This act shall take effect on the first of January next succeeding the date on which it shall have become law and shall apply to policies and contracts issued, renewed, modified, altered or amended on and after such date.
Go to top

A01682 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         1682--A
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 17, 2023
                                       ___________
 
        Introduced  by  M. of A. WOERNER, SIMON, DICKENS, THIELE, CRUZ, GUNTHER,
          SEAWRIGHT, GLICK, REYES -- Multi-Sponsored by -- M. of  A.  SAYEGH  --
          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 prohibiting the exclu-
          sion of coverage based upon gender indication on claim forms
 
          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 39 to read as follows:
     3    (39) Every policy that provides coverage  for  hospital,  surgical  or
     4  medical  care  shall  not  exclude coverage for screening, diagnosis and
     5  treatment of medical conditions, or services otherwise  covered  by  the
     6  policy  solely  on the basis of the gender indicated on a claim form, or
     7  that the gender  indicated  on  a  claim  form  is  different  from  the
     8  insured's  sex  assigned  at birth or gender otherwise recorded, or that
     9  the insured is not of the gender to whom a service is provided.  Nothing
    10  herein  shall  limit  the  insurer's  ability  to take reasonable steps,
    11  including requesting additional information, to  determine  whether  the
    12  insured  is eligible for the services, to review the claim for potential
    13  fraud, or to review the claim for clinical appropriateness.
    14    § 2. Subsection (l) of section 3221 of the insurance law is amended by
    15  adding a new paragraph 22 to read as follows:
    16    (22) Every policy that provides coverage  for  hospital,  surgical  or
    17  medical  care  shall  not  exclude coverage for screening, diagnosis and
    18  treatment of medical conditions, or services otherwise  covered  by  the
    19  policy  solely  on the basis of the gender indicated on a claim form, or
    20  that the gender  indicated  on  a  claim  form  is  different  from  the
    21  insured's  sex  assigned  at birth or gender otherwise recorded, or that
    22  the insured is not of the gender to whom a service is provided.  Nothing
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04905-03-3

        A. 1682--A                          2
 
     1  herein  shall  limit  the  insurer's  ability  to take reasonable steps,
     2  including requesting additional information, to  determine  whether  the
     3  insured  is eligible for the services, to review the claim for potential
     4  fraud, or to review the claim for clinical appropriateness.
     5    §  3.  Section  4303  of  the insurance law is amended by adding a new
     6  subsection (vv) to read as follows:
     7    (vv) Every contract that provides coverage for hospital,  surgical  or
     8  medical  care  shall  not  exclude coverage for screening, diagnosis and
     9  treatment of medical conditions, or services otherwise  covered  by  the
    10  contract solely on the basis of the gender indicated on a claim form, or
    11  that  the  gender  indicated  on  a  claim  form  is  different from the
    12  insured's sex assigned at birth or gender otherwise  recorded,  or  that
    13  the  insured is not of the gender to whom a service is provided. Nothing
    14  herein shall limit the  insurer's  ability  to  take  reasonable  steps,
    15  including  requesting  additional  information, to determine whether the
    16  insured is eligible for the services, to review the claim for  potential
    17  fraud, or to review the claim for clinical appropriateness.
    18    §  4. This act shall take effect on the first of January next succeed-
    19  ing the date on which it shall have become a  law  and  shall  apply  to
    20  policies  and contracts issued, renewed, modified, altered or amended on
    21  or after such effective date.
Go to top