A02945 Summary:

BILL NOA02945
 
SAME ASNo same as
 
SPONSORGlick (MS)
 
COSPNSRJacobs, Dinowitz, Weinstein, Jaffee
 
MLTSPNSRCymbrowitz, Galef, O'Donnell, Ortiz, Paulin, Scarborough
 
Amd SS3216, 3221 & 4303, Ins L
 
Requires provision be made for pregnancy termination procedures insurance coverage in every individual or group hospital, surgical or medical policy, or hospital service or medical expense indemnity contract of a service corporation, only where any such policy or contract offers maternity care coverage.
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A02945 Actions:

BILL NOA02945
 
01/21/2011referred to insurance
01/04/2012referred to insurance
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A02945 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A2945
 
SPONSOR: Glick (MS)
  TITLE OF BILL: An act to amend the insurance law, in relation to requiring that provision be made for pregnancy termination procedures in every individual or group policy or contract which provides coverage or indemnity for hospital, surgical or medical care and which offers mater- nity care coverage   PURPOSE OR GENERAL IDEA OF BILL: To require every health insurance policy which provides coverage for hospital, surgical or medical care and which offers maternity care coverage to include coverage for the cost of pregnancy termination.   SUMMARY OF SPECIFIC PROVISIONS: Adds a new paragraph 10-a to subsection (i) of § 3216, adds new para- graph 5-a of subsection (k) of § 3221, and adds new subsection (c-l) to § 4303 of the insurance law to require every insurance policy providing maternity care coverage to also provide coverage for pregnancy termi- nation. In addition, such coverage shall be: subject to guidelines recognized by the American Medical Association, confidential, subject to annual deductibles and coinsurance, and shall not restrict existing coverage.   JUSTIFICATION: Managed care and health insurance companies have, in attempts to reduce costs, restricted access to a variety of procedures. They have substi- tuted their perspectives of what is or isn't important over that of physicians and patients. It is a reasonable expectation on the part of women that all aspects of their health needs will be covered by their health insurance. This legislation would ensure that women with health insurance will not be deprived of health care options based on afforda- bility.   PRIOR LEGISLATIVE HISTORY: 2009-10 - A.2561 Referred to Insurance 2007-08 - A.1935 Referred to Insurance 2005-06 - A.1948 Referred to Insurance 2003-04 - A.2611 Referred to Insurance 2001-02 - A.2412 Referred to Insurance 1999-00 - S.1119 Referred to Insurance / A.3964 Passed Assembly. 1998 - S.5032 Referred to Insurance / A.3570 Referred to Insurance. 1997 - S.5032 Referred to Insurance / A.3570 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 a law and shall only apply to poli- cies and contracts issued, renewed, modified, altered or amended on or after such date.
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A02945 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          2945
 
                               2011-2012 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 21, 2011
                                       ___________
 
        Introduced  by  M.  of  A. GLICK, JACOBS, DINOWITZ, WEINSTEIN, JAFFEE --
          Multi-Sponsored by -- M.  of A. CYMBROWITZ, GALEF,  O'DONNELL,  ORTIZ,
          PAULIN,  SCARBOROUGH  --  read  once  and referred to the Committee on
          Insurance
 
        AN ACT to amend  the  insurance  law,  in  relation  to  requiring  that

          provision  be made for pregnancy termination procedures in every indi-
          vidual or group policy or contract which provides coverage  or  indem-
          nity for hospital, surgical or medical care and which offers maternity
          care coverage
 
          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 10-a to read as follows:
     3    (10-a)  (A)  Every policy which provides hospital, surgical or medical
     4  coverage and which offers maternity care coverage pursuant to  paragraph
     5  ten  of this subsection shall also provide coverage for pregnancy termi-
     6  nation procedures which are performed by a licensed physician, upon  the

     7  policyholder  or  upon  his  spouse or upon a nonspouse who is dependent
     8  upon the policyholder, in any  licensed  hospital  or  medical  facility
     9  approved  by  the  state commissioner of health, to the same extent that
    10  coverage is provided for illness or disease under the policy, subject to
    11  the provisions of this paragraph.
    12    (B) Provision for such coverage shall be  subject  to  any  guidelines
    13  which  are  now  or  hereafter issued by the medical specialty societies
    14  recognized by the American Board of Medical  Specialties  of  obstetrics
    15  and gynecology, for pregnancy terminations and abortions.
    16    (C)  Such  coverage  shall  be  provided in a manner which ensures the
    17  confidentiality  and  privacy  of  the  occurrence  of  the   procedures

    18  performed to the person for whom coverage is provided.
    19    (D) Such coverage may be subject to annual deductibles and coinsurance
    20  as may be deemed appropriate by the superintendent and as are consistent
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05938-01-1

        A. 2945                             2
 
     1  with  those  established  for  other benefits within a given policy, but
     2  such coverage shall not be subject to the reimbursement  period  limita-
     3  tion  or  minimum  period of coverage limitation applicable to maternity
     4  care coverage.

     5    (E)  Coverage  under  this  paragraph  shall not restrict or eliminate
     6  existing coverage provided by the policy and nothing in  this  paragraph
     7  shall  be construed to deny or restrict in any way any existing right or
     8  benefit provided under law or by contract.
     9    § 2. Subsection (k) of section 3221 of the insurance law is amended by
    10  adding a new paragraph 5-a to read as follows:
    11    (5-a) (A) Every group or blanket policy delivered or issued for deliv-
    12  ery in this state which provides hospital, surgical or medical  coverage
    13  and  which  offers maternity care coverage pursuant to paragraph five of
    14  this subsection shall also provide coverage  for  pregnancy  termination
    15  procedures  which are performed by a licensed physician, upon the policy

    16  beneficiary certificate holder or upon his spouse or  upon  a  nonspouse
    17  who  is dependent upon the policy beneficiary certificate holder, in any
    18  licensed hospital or medical facility approved by the state commissioner
    19  of health, to the same extent that coverage is provided for  illness  or
    20  disease under the policy, subject to the provisions of this paragraph.
    21    (B)  Provision  for  such  coverage shall be subject to any guidelines
    22  which are now or hereafter issued by  the  medical  specialty  societies
    23  recognized  by  the  American Board of Medical Specialties of obstetrics
    24  and gynecology, for pregnancy terminations and abortions.
    25    (C) Such coverage shall be provided in  a  manner  which  ensures  the

    26  confidentiality   and  privacy  of  the  occurrence  of  the  procedures
    27  performed to the person for whom coverage is provided.
    28    (D) Such coverage may be subject to annual deductibles and coinsurance
    29  as may be deemed appropriate by the superintendent and as are consistent
    30  with those established for other benefits within  a  given  policy,  but
    31  such  coverage  shall not be subject to the reimbursement period limita-
    32  tion or minimum period of coverage limitation  applicable  to  maternity
    33  care coverage.
    34    (E)  Coverage  under  this  paragraph  shall not restrict or eliminate
    35  existing coverage provided by the policy and nothing in  this  paragraph
    36  shall  be construed to deny or restrict in any way any existing right or

    37  benefit provided under law or by contract.
    38    § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
    39  subsection (c-1) to read as follows:
    40    (c-1)  (A)  Every  contract  issued  by  a  corporation subject to the
    41  provisions of this article  which  provides  hospital  service,  medical
    42  expense  indemnity,  or  both,  and which offers maternity care coverage
    43  pursuant to subsection (c) of this section shall also  provide  coverage
    44  for  pregnancy  termination procedures which are performed by a licensed
    45  physician, upon the contract beneficiary certificate holder or upon  his
    46  spouse  or upon a nonspouse who is dependent upon the contract benefici-
    47  ary certificate holder, in any licensed  hospital  or  medical  facility

    48  approved  by  the  state commissioner of health, to the same extent that
    49  coverage is provided for illness or disease under the contract,  subject
    50  to the provisions of this subsection.
    51    (B)  Provision  for  such  coverage shall be subject to any guidelines
    52  which are now or hereafter issued by  the  medical  specialty  societies
    53  recognized  by  the  American Board of Medical Specialties of obstetrics
    54  and gynecology, for pregnancy terminations and abortions.

        A. 2945                             3
 
     1    (C) Such coverage shall be provided in  a  manner  which  ensures  the
     2  confidentiality   and  privacy  of  the  occurrence  of  the  procedures
     3  performed to the person for whom coverage is provided.

     4    (D) Such coverage may be subject to annual deductibles and coinsurance
     5  as may be deemed appropriate by the superintendent and as are consistent
     6  with  those  established for other benefits within a given contract, but
     7  such coverage shall not be subject to the reimbursement  period  limita-
     8  tion  or  minimum  period of coverage limitation applicable to maternity
     9  care coverage.
    10    (E) Coverage under this subsection shall  not  restrict  or  eliminate
    11  existing   coverage  provided  by  the  contract  and  nothing  in  this
    12  subsection shall be construed to deny or restrict in any way any  exist-
    13  ing right or benefit provided under law or by contract.
    14    §  4. This act shall take effect on the first of January next succeed-

    15  ing the date on which it shall have become a law and shall only apply to
    16  policies and contracts issued, renewed, modified, altered or amended  on
    17  or after such date.
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