STATE OF NEW YORK
________________________________________________________________________
2212
2017-2018 Regular Sessions
IN ASSEMBLY
January 17, 2017
___________
Introduced by M. of A. GUNTHER, ORTIZ, ROSENTHAL, JAFFEE, PERRY, HOOPER,
DINOWITZ, ZEBROWSKI, TITONE, RIVERA, ABINANTI, COLTON, DenDEKKER,
M. G. MILLER, McKEVITT, RAIA, SALADINO, LALOR -- Multi-Sponsored by --
M. of A. ABBATE, BENEDETTO, COOK, CROUCH, CUSICK, GALEF, GIGLIO,
GOTTFRIED, LUPARDO, MAGNARELLI, McDONOUGH, MONTESANO, PAULIN, SKARTA-
DOS, THIELE -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to mandatory health
insurance coverage for providing prosthetic devices
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 provide coverage for prosthetic
5 devices, including repairs and replacements, that are intended for
6 medically necessary rehabilitative and habilitative purposes as required
7 by 42 U.S.C. §18022. As such, prosthetic device coverage shall be
8 subject to annual deductibles and coinsurance as deemed appropriate by
9 the superintendent in amounts no greater than other essential health
10 benefits covered by the policy. The term "prosthetic device" as used in
11 this paragraph includes an artificial limb and all of the components and
12 related services that comprise prosthetic care but shall not include
13 shoes or any other article considered as ordinary wearing apparel,
14 whether or not specially constructed.
15 § 2. Subsection (l) of section 3221 of the insurance law is amended by
16 adding a new paragraph 20 to read as follows:
17 (20) Every policy which provides medical, major medical, or similar
18 comprehensive type coverage shall provide coverage for prosthetic
19 devices, including repairs and replacements, that are intended for
20 medically necessary rehabilitative and habilitative purposes as required
21 by 42 U.S.C. §18022. As such, prosthetic device coverage shall be
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD03027-01-7
A. 2212 2
1 subject to annual deductibles and coinsurance as deemed appropriate by
2 the superintendent in amounts no greater than other essential health
3 benefits covered by the policy. The term "prosthetic device" as used in
4 this paragraph includes an artificial limb and all of the components and
5 related services that comprise prosthetic care but shall not include
6 shoes or any other article considered as ordinary wearing apparel,
7 whether or not specially constructed.
8 § 3. Section 4303 of the insurance law is amended by adding a new
9 subsection (rr) to read as follows:
10 (rr) Every policy which provides medical, major medical, or similar
11 comprehensive type coverage shall provide coverage for prosthetic
12 devices, including repairs and replacements, that are intended for
13 medically necessary rehabilitative and habilitative purposes as required
14 by 42 U.S.C. §18022. As such, prosthetic device coverage shall be
15 subject to annual deductibles and coinsurance as deemed appropriate by
16 the superintendent in amounts no greater than other essential health
17 benefits covered by the policy. The term "prosthetic device" as used in
18 this subsection includes an artificial limb and all of the components
19 and related services that comprise prosthetic care but shall not include
20 shoes or any other article considered as ordinary wearing apparel,
21 whether or not specially constructed.
22 § 4. This act shall take effect on the ninetieth day after it shall
23 have become a law and shall apply to policies and contracts issued,
24 renewed, modified, altered or amended on or after such effective date.
