Assembly Bill A6496

2013-2014 Legislative Session

Requires insurance coverage for craniofacial disorders

download bill text pdf

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Archive: Last Bill Status - In Assembly Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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2013-A6496 (ACTIVE) - Details

See Senate Version of this Bill:
S1049
Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: A375, S6996
2011-2012: A2622, S139

2013-A6496 (ACTIVE) - Summary

Requires insurance coverage under health insurance plans for diagnosis and treatment of craniofacial disorder; provides a referral from a health care provider under contract with the policy may be required.

2013-A6496 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  6496

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                              April 4, 2013
                               ___________

Introduced by M. of A. JACOBS -- read once and referred to the Committee
  on Insurance

AN  ACT  to  amend  the  insurance  law, in relation to health insurance
  coverage for craniofacial disorders

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
amended by adding a new paragraph 30 to read as follows:
  (30)(A) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY  IN  THIS  STATE
WHICH  PROVIDES  MEDICAL  COVERAGE  THAT INCLUDES COVERAGE FOR PHYSICIAN
SERVICES IN A PHYSICIAN'S OFFICE AND EVERY POLICY WHICH  PROVIDES  MAJOR
MEDICAL  OR  SIMILAR  COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE
FOR DIAGNOSIS AND MEDICALLY NECESSARY TREATMENT, INCLUDING SURGICAL  AND
NONSURGICAL  PROCEDURES, FOR A MUSCULOSKELETAL DISORDER THAT AFFECTS ANY
BONE OR JOINT IN THE FACE, NECK OR HEAD AND IS THE RESULT  OF  ACCIDENT,
TRAUMA,  CONGENITAL  DEFECT, DEVELOPMENTAL DEFECT, OR PATHOLOGY. SUBJECT
TO SUBPARAGRAPH (B) OF THIS PARAGRAPH, THIS COVERAGE SHALL BE  THE  SAME
AS  THAT  PROVIDED  UNDER THE HEALTH INSURANCE PLAN FOR ANY OTHER MUSCU-
LOSKELETAL DISORDER IN THE BODY AND MAY BE PROVIDED WHEN  PRESCRIBED  OR
ADMINISTERED  BY  A  PHYSICIAN OR A DENTIST. THIS PARAGRAPH SHALL NOT BE
CONSTRUED TO REQUIRE COVERAGE FOR DENTAL SERVICES FOR THE  DIAGNOSIS  OR
TREATMENT  OF  DENTAL  DISORDERS OR DENTAL PATHOLOGY PRIMARILY AFFECTING
THE GUMS, TEETH, OR ALVEOLAR RIDGE.
  (B) A REFERRAL FROM A HEALTH CARE PROVIDER  UNDER  CONTRACT  WITH  THE
POLICY MAY BE REQUIRED.
  S 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 19 to read as follows:
  (19)(A) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY
IN THIS STATE WHICH PROVIDES MEDICAL COVERAGE THAT INCLUDES COVERAGE FOR
PHYSICIAN  SERVICES  IN A PHYSICIAN'S OFFICE OR MAJOR MEDICAL OR SIMILAR
COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE  COVERAGE  FOR  DIAGNOSIS  AND

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD02286-01-3
              

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