A03867 Summary:

BILL NOA03867
 
SAME ASNo Same As
 
SPONSORGlick
 
COSPNSRDinowitz, Weinstein, Jaffee, Rosenthal, Gottfried, Abinanti
 
MLTSPNSRCymbrowitz, Galef, O'Donnell, Ortiz, Paulin
 
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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A03867 Actions:

BILL NOA03867
 
01/27/2015referred to insurance
01/06/2016referred to insurance
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A03867 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          3867
 
                               2015-2016 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 27, 2015
                                       ___________
 
        Introduced  by  M.  of A. GLICK, DINOWITZ, WEINSTEIN, JAFFEE, ROSENTHAL,
          GOTTFRIED, ABINANTI -- 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.
                                                                   LBD03875-01-5

        A. 3867                             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. 3867                             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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