Bill S2405-2015

Relates to telehealth delivery of services; repealer

Relates to telehealth delivery of services.

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Actions

  • Feb 25, 2015: SUBSTITUTED BY A2552A
  • Jan 26, 2015: ORDERED TO THIRD READING CAL.46
  • Jan 23, 2015: REFERRED TO RULES

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Memo

BILL NUMBER:S2405

TITLE OF BILL: An act to amend the public health law, the insurance law and the social services law, in relation to the telehealth delivery of services; to amend chapter 550 of the laws of 2014, amending the public health law, the insurance law and the social services law, relating to the telehealth delivery of services, in relation to the effectiveness thereof; and to repeal certain provisions of the public health law and the insurance law relating thereto

PURPOSE: Requires insurers and medical assistance for needy persons to provide coverage for the provision of telehealth and telemedicine services.

SUMMARY OF PROVISIONS:

Section one would repeal superseded paragraphs of subdivision 1 of section 2 of the public health law.

Section two would add a new article 29-G to the public health law to provide definitions for "distant site," "telehealth provider," "originating site," "telehealth," "telemedicine," "store and forward technology," and "remote patient monitoring."

Section three would repeal superseded paragraph 30 of subsection (1) of section 3216 of the insurance law.

Section four would add a new section 3217-h to the insurance law to require insurers to provide coverage for services delivered via telehealth, as long as such services and providers of the services are otherwise covered under the instant contract or policy. Such coverage is subject to contractual limits including annual deductibles, coinsurance, utilization management, and other managed care tools on par with the same services when not provided via telehealth.

Section five would repeal superseded paragraph 19 of subsection (k) of section 3221.

Section six would amend the insurance law to remove a contingency that services delivered via telehealth under a long term care plan are only reimbursable pursuant to an agreement.

Section seven would repeal superseded subsection (oo) of section 4303 of the insurance law.

Section eight would add a new section 4306-g to the insurance law to require non-profit medical and dental indemnity or health and hospital service corporations to provide coverage for services delivered via telehealth, as long as such services and providers of the services are otherwise covered under the instant contract or policy. Such coverage is subject to contractual limits including annual deductibles, coinsurance, utilization management, and other managed care tools on par with the same services when not provided via telehealth.

Section nine would add a new section 4406-g to the public health law to require health maintenance organizations to provide coverage for

services delivered via telehealth, as long as such services and providers of the services are otherwise covered under the instant contract or policy. Such coverage is subject to contractual limits including annual deductibles, coinsurance, utilization management, and other managed care tools on par with the same services when not provided via telehealth.

Section ten would provide for the provision of coverage of services delivered via telehealth under Medicaid.

Section eleven would amend the effective date of chapter 550 of the laws of 2014.

Section twelve would establish the effective date and authorize the commissioner of health to promulgate regulations necessary to implement the provisions of the act.

JUSTIFICATION: Telehealth can dramatically increase access to health services for patients who face challenges in accessing health care providers in-person, whether due to geographic distance, provider shortage, weather, or restricted patient mobility.

With the provision of health services via telehealth, patients see fewer hospitalizations and costly visits to emergency rooms; expanded access to providers; faster, more convenient and timely treatment; better continuity of care; better coordination of care; reduction of lost work time and travel costs; and the ability to remain within support networks and age in place at home.

Persons of all ages who suffer from chronic diseases will have the opportunity to stay in their homes longer, abnormal events may be detected before they turn into a hospital visit, and vital signs can be monitored remotely by registered nurses. Moreover, patients can get help with medication adherence, and can be encouraged to take ownership of their own well-being by better understanding the correlation between their choices and their health outcomes.

The instant bill defines telehealth as the use of electronic information and telecommunications technologies by telehealth providers to deliver health care services, which shall include the assessment, diagnosis, consultation, treatment, education, care management and/or self-management of a patient.

Health insurers, including Medicaid, would provide coverage for services delivered via telehealth, as long as such services and providers of the services are otherwise covered under the patient's contract or policy. Providers include physicians, physician assistants, dentists, nurse practitioners, registered professional nurses, podiatrists, optometrists, psychologists, social workers, speech pathologists, midwives, diabetes educators, asthma educators, genetic counselors, hospitals, home care services agencies, hospices, or other providers as determined by the commissioner of health.

This bill does not require that services delivered via telehealth be covered if such services are not already covered under the existing contract or policy. Further, coverage would remain subject to contractual limits including annual deductibles, coinsurance,

utilization management, and other managed care tools at least as favorable as the same services not provided via telehealth.

Telehealth is a vital tool in improving the continuity, coordination, and efficiency of care, especially as New York moves toward population health and value-based models of health care. Thus, this bill will help bring much-needed and often vital health care services to rural and underserved populations.

LEGISLATIVE HISTORY: This bill amends chapter 550 of the laws of 2014.

FISCAL IMPLICATIONS: This bill will have no fiscal implications as the provided services are those otherwise covered under the relevant policy. All Medicaid provisions are subject to the approval of the Director of the Budget.

EFFECTIVE DATE: Effective January 1, 2016, and shall apply to all policies and contracts issued, renewed, modified, altered or amended on or after such date.


Text

STATE OF NEW YORK ________________________________________________________________________ 2405 2015-2016 Regular Sessions IN SENATE January 23, 2015 ___________
Introduced by Sen. YOUNG -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the public health law, the insurance law and the social services law, in relation to the telehealth delivery of services; to amend chapter 550 of the laws of 2014, amending the public health law, the insurance law and the social services law, relating to the tele- health delivery of services, in relation to the effectiveness thereof; and to repeal certain provisions of the public health law and the insurance law relating thereto THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraphs (o), (p), (q), (r) and (s) of subdivision 1 of section 2 of the public health law are REPEALED. S 2. The public health law is amended by adding a new article 29-G to read as follows: ARTICLE 29-G TELEHEALTH DELIVERY OF SERVICES SECTION 2999-CC. DEFINITIONS. 2999-DD. TELEHEALTH DELIVERY OF SERVICES. S 2999-CC. DEFINITIONS. AS USED IN THIS ARTICLE, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS: 1. "DISTANT SITE" MEANS A SITE AT WHICH A TELEHEALTH PROVIDER IS LOCATED WHILE DELIVERING HEALTH CARE SERVICES BY MEANS OF TELEHEALTH. 2. "TELEHEALTH PROVIDER" MEANS: (A) A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW; (B) A PHYSICIAN ASSISTANT LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW; (C) A DENTIST LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-THREE OF THE EDUCATION LAW;
(D) A NURSE PRACTITIONER LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-NINE OF THE EDUCATION LAW; (E) A REGISTERED PROFESSIONAL NURSE LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-NINE OF THE EDUCATION LAW ONLY WHEN SUCH NURSE IS RECEIV- ING PATIENT-SPECIFIC HEALTH INFORMATION OR MEDICAL DATA AT A DISTANT SITE BY MEANS OF REMOTE PATIENT MONITORING; (F) A PODIATRIST LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY-ONE OF THE EDUCATION LAW; (G) AN OPTOMETRIST LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY-THREE OF THE EDUCATION LAW; (H) A PSYCHOLOGIST LICENSED PURSUANT TO ARTICLE ONE HUNDRED FIFTY-THREE OF THE EDUCATION LAW; (I) A SOCIAL WORKER LICENSED PURSUANT TO ARTICLE ONE HUNDRED FIFTY-FOUR OF THE EDUCATION LAW; (J) A SPEECH LANGUAGE PATHOLOGIST OR AUDIOLOGIST LICENSED PURSUANT TO ARTICLE ONE HUNDRED FIFTY-NINE OF THE EDUCATION LAW; (K) A MIDWIFE LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY OF THE EDUCATION LAW; (L) A PERSON WHO IS CERTIFIED AS A DIABETES EDUCATOR BY THE NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS, OR A SUCCESSOR NATIONAL CERTIFICATION BOARD, OR PROVIDED BY SUCH A PROFESSIONAL WHO IS AFFIL- IATED WITH A PROGRAM CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION, THE AMERICAN ASSOCIATION OF DIABETES EDUCATORS, THE INDIAN HEALTH SERVICES, OR ANY OTHER NATIONAL ACCREDITATION ORGANIZATION APPROVED BY THE FEDERAL CENTERS FOR MEDICARE AND MEDICAID SERVICES; (M) A PERSON WHO IS CERTIFIED AS AN ASTHMA EDUCATOR BY THE NATIONAL ASTHMA EDUCATOR CERTIFICATION BOARD, OR A SUCCESSOR NATIONAL CERTIF- ICATION BOARD; (N) A PERSON WHO IS CERTIFIED AS A GENETIC COUNSELOR BY THE AMERICAN BOARD OF GENETIC COUNSELING, OR A SUCCESSOR NATIONAL CERTIFICATION BOARD; (O) A HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF THIS CHAPTER; (P) A HOME CARE SERVICES AGENCY AS DEFINED IN ARTICLE THIRTY-SIX OF THIS CHAPTER; (Q) A HOSPICE AS DEFINED IN ARTICLE FORTY OF THIS CHAPTER; AND (R) ANY OTHER PROVIDER AS DETERMINED BY THE COMMISSIONER PURSUANT TO REGULATION. 3. "ORIGINATING SITE" MEANS A SITE AT WHICH A PATIENT IS LOCATED AT THE TIME HEALTH CARE SERVICES ARE DELIVERED TO HIM OR HER BY MEANS OF TELEHEALTH. ORIGINATING SITES SHALL BE LIMITED TO FACILITIES LICENSED UNDER ARTICLES TWENTY-EIGHT AND FORTY OF THIS CHAPTER, FACILITIES AS DEFINED IN SUBDIVISION SIX OF SECTION 1.03 OF THE MENTAL HYGIENE LAW, PRIVATE PHYSICIAN'S OFFICES LOCATED WITHIN THE STATE OF NEW YORK AND, WHEN A PATIENT IS RECEIVING HEALTH CARE SERVICES BY MEANS OF REMOTE PATIENT MONITORING, THE PATIENT'S PLACE OF RESIDENCE LOCATED WITHIN THE STATE OF NEW YORK OR OTHER TEMPORARY LOCATION LOCATED WITHIN OR OUTSIDE THE STATE OF NEW YORK. 4. "TELEHEALTH" MEANS THE USE OF ELECTRONIC INFORMATION AND COMMUNI- CATION TECHNOLOGIES BY TELEHEALTH PROVIDERS TO DELIVER HEALTH CARE SERVICES, WHICH SHALL INCLUDE THE ASSESSMENT, DIAGNOSIS, CONSULTATION, TREATMENT, EDUCATION, CARE MANAGEMENT AND/OR SELF-MANAGEMENT OF A PATIENT. TELEHEALTH SHALL NOT INCLUDE DELIVERY OF HEALTH CARE SERVICES BY MEANS OF AUDIO-ONLY TELEPHONE COMMUNICATION, FACSIMILE MACHINES, OR ELECTRONIC MESSAGING ALONE, THOUGH USE OF THESE TECHNOLOGIES IS NOT PRECLUDED IF USED IN CONJUNCTION WITH TELEMEDICINE, STORE AND FORWARD TECHNOLOGY, OR REMOTE PATIENT MONITORING. FOR PURPOSES OF THIS SECTION,
TELEHEALTH SHALL BE LIMITED TO TELEMEDICINE, STORE AND FORWARD TECHNOLO- GY, AND REMOTE PATIENT MONITORING. THIS SUBDIVISION SHALL NOT PRECLUDE THE DELIVERY OF HEALTH CARE SERVICES BY MEANS OF "HOME TELEHEALTH" AS USED IN SECTION THIRTY-SIX HUNDRED FOURTEEN OF THIS CHAPTER. 5. "TELEMEDICINE" MEANS THE USE OF SYNCHRONOUS, TWO-WAY ELECTRONIC AUDIO VISUAL COMMUNICATIONS TO DELIVER CLINICAL HEALTH CARE SERVICES, WHICH SHALL INCLUDE THE ASSESSMENT, DIAGNOSIS, AND TREATMENT OF A PATIENT, WHILE SUCH PATIENT IS AT THE ORIGINATING SITE AND A TELEHEALTH PROVIDER IS AT A DISTANT SITE. 6. "STORE AND FORWARD TECHNOLOGY" MEANS THE ASYNCHRONOUS, ELECTRONIC TRANSMISSION OF A PATIENT'S HEALTH INFORMATION IN THE FORM OF PATIENT-SPECIFIC DIGITAL IMAGES AND/OR PRE-RECORDED VIDEOS FROM A PROVIDER AT AN ORIGINATING SITE TO A TELEHEALTH PROVIDER AT A DISTANT SITE. 7. "REMOTE PATIENT MONITORING" MEANS THE USE OF SYNCHRONOUS OR ASYN- CHRONOUS ELECTRONIC INFORMATION AND COMMUNICATION TECHNOLOGIES TO COLLECT PERSONAL HEALTH INFORMATION AND MEDICAL DATA FROM A PATIENT AT AN ORIGINATING SITE THAT IS TRANSMITTED TO A TELEHEALTH PROVIDER AT A DISTANT SITE FOR USE IN THE TREATMENT AND MANAGEMENT OF MEDICAL CONDI- TIONS THAT REQUIRE FREQUENT MONITORING. SUCH CONDITIONS SHALL INCLUDE, BUT NOT BE LIMITED TO, CONGESTIVE HEART FAILURE, DIABETES, CHRONIC OBSTRUCTIVE PULMONARY DISEASE, WOUND CARE, POLYPHARMACY, MENTAL OR BEHAVIORAL PROBLEMS, AND TECHNOLOGY-DEPENDENT CARE SUCH AS CONTINUOUS OXYGEN, VENTILATOR CARE, TOTAL PARENTERAL NUTRITION OR ENTERAL FEEDING. REMOTE PATIENT MONITORING SHALL BE ORDERED BY A PHYSICIAN LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION LAW, A NURSE PRACTITIONER LICENSED PURSUANT TO ARTICLE ONE HUNDRED THIRTY-NINE OF THE EDUCATION LAW, OR A MIDWIFE LICENSED PURSUANT TO ARTICLE ONE HUNDRED FORTY OF THE EDUCATION LAW, WITH WHICH THE PATIENT HAS A SUBSTANTIAL AND ONGOING RELATIONSHIP. S 2999-DD. TELEHEALTH DELIVERY OF SERVICES. HEALTH CARE SERVICES DELIVERED BY MEANS OF TELEHEALTH SHALL BE ENTITLED TO REIMBURSEMENT UNDER SECTION THREE HUNDRED SIXTY-SEVEN-U OF THE SOCIAL SERVICES LAW. S 3. Paragraph 30 of subsection (i) of section 3216 of the insurance law, as added by chapter 550 of the laws of 2014, is REPEALED. S 4. The insurance law is amended by adding a new section 3217-h to read as follows: S 3217-H. TELEHEALTH DELIVERY OF SERVICES. (A) AN INSURER SHALL NOT EXCLUDE FROM COVERAGE A SERVICE THAT IS OTHERWISE COVERED UNDER A POLICY THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL, MEDICAL OR SURGICAL CARE BECAUSE THE SERVICE IS DELIVERED VIA TELEHEALTH, AS THAT TERM IS DEFINED IN SUBSECTION (B) OF THIS SECTION; PROVIDED, HOWEVER, THAT AN INSURER MAY EXCLUDE FROM COVERAGE A SERVICE BY A HEALTH CARE PROVIDER WHERE THE PROVIDER IS NOT OTHERWISE COVERED UNDER THE POLICY. AN INSURER MAY SUBJECT THE COVERAGE OF A SERVICE DELIVERED VIA TELEHEALTH TO CO-PAYMENTS, COINSURANCE OR DEDUCTIBLES PROVIDED THAT THEY ARE AT LEAST AS FAVORABLE TO THE INSURED AS THOSE ESTABLISHED FOR THE SAME SERVICE WHEN NOT DELIVERED VIA TELEHEALTH. AN INSURER MAY SUBJECT THE COVERAGE OF A SERVICE DELIVERED VIA TELEHEALTH TO REASONABLE UTILIZATION MANAGE- MENT AND QUALITY ASSURANCE REQUIREMENTS THAT ARE CONSISTENT WITH THOSE ESTABLISHED FOR THE SAME SERVICE WHEN NOT DELIVERED VIA TELEHEALTH. (B) FOR PURPOSES OF THIS SECTION, "TELEHEALTH" MEANS THE USE OF ELEC- TRONIC INFORMATION AND COMMUNICATION TECHNOLOGIES BY A HEALTH CARE PROVIDER TO DELIVER HEALTH CARE SERVICES TO AN INSURED INDIVIDUAL WHILE SUCH INDIVIDUAL IS LOCATED AT A SITE THAT IS DIFFERENT FROM THE SITE WHERE THE HEALTH CARE PROVIDER IS LOCATED.
S 5. Paragraph 19 of subsection (k) of section 3221 of the insurance law, as added by chapter 550 of the laws of 2014, is REPEALED. S 6. Paragraph 2 of subsection (a) of section 3229 of the insurance law, as amended by chapter 550 of the laws of 2014, is amended to read as follows: (2) a home care benefit with personal care, nursing care, adult day health care[,] AND respite care services, [telemedicine services, as defined in section two of the public health law, provided that such telemedicine services are pursuant to an agreement between a provider participating in the insurer's network and the insurer, and meet the requirements of federal law, rules and regulations for Medicare, or telehealth services, as defined by section two of the public health law, provided that such services are consistent with subdivision three-c of section thirty-six hundred fourteen of the public health law. The provider of such services shall meet the terms and conditions (to the extent not inconsistent with this paragraph) of his or her contract with the insurer,] which shall provide total benefits in an amount determined by regulations of the superintendent; S 7. Subsection (oo) of section 4303 of the insurance law is REPEALED. S 8. The insurance law is amended by adding a new section 4306-g to read as follows: S 4306-G. TELEHEALTH DELIVERY OF SERVICES. (A) A CORPORATION SHALL NOT EXCLUDE FROM COVERAGE A SERVICE THAT IS OTHERWISE COVERED UNDER A CONTRACT THAT PROVIDES COMPREHENSIVE COVERAGE FOR HOSPITAL, MEDICAL OR SURGICAL CARE BECAUSE THE SERVICE IS DELIVERED VIA TELEHEALTH, AS THAT TERM IS DEFINED IN SUBSECTION (B) OF THIS SECTION; PROVIDED, HOWEVER, THAT A CORPORATION MAY EXCLUDE FROM COVERAGE A SERVICE BY A HEALTH CARE PROVIDER WHERE THE PROVIDER IS NOT OTHERWISE COVERED UNDER THE CONTRACT. A CORPORATION MAY SUBJECT THE COVERAGE OF A SERVICE DELIVERED VIA TELE- HEALTH TO CO-PAYMENTS, COINSURANCE OR DEDUCTIBLES PROVIDED THAT THEY ARE AT LEAST AS FAVORABLE TO THE INSURED AS THOSE ESTABLISHED FOR THE SAME SERVICE WHEN NOT DELIVERED VIA TELEHEALTH. A CORPORATION MAY SUBJECT THE COVERAGE OF A SERVICE DELIVERED VIA TELEHEALTH TO REASONABLE UTILIZATION MANAGEMENT AND QUALITY ASSURANCE REQUIREMENTS THAT ARE CONSISTENT WITH THOSE ESTABLISHED FOR THE SAME SERVICE WHEN NOT DELIVERED VIA TELE- HEALTH. (B) FOR PURPOSES OF THIS SECTION, "TELEHEALTH" MEANS THE USE OF ELEC- TRONIC INFORMATION AND COMMUNICATION TECHNOLOGIES BY A HEALTH CARE PROVIDER TO DELIVER HEALTH CARE SERVICES TO AN INSURED INDIVIDUAL WHILE SUCH INDIVIDUAL IS LOCATED AT A SITE THAT IS DIFFERENT FROM THE SITE WHERE THE HEALTH CARE PROVIDER IS LOCATED. S 9. The public health law is amended by adding a new section 4406-g to read as follows: S 4406-G. TELEHEALTH DELIVERY OF SERVICES. 1. A HEALTH MAINTENANCE ORGANIZATION SHALL NOT EXCLUDE FROM COVERAGE A SERVICE THAT IS OTHERWISE COVERED UNDER AN ENROLLEE CONTRACT OF A HEALTH MAINTENANCE ORGANIZATION BECAUSE THE SERVICE IS DELIVERED VIA TELEHEALTH, AS THAT TERM IS DEFINED IN SUBDIVISION TWO OF THIS SECTION; PROVIDED, HOWEVER, THAT A HEALTH MAINTENANCE ORGANIZATION MAY EXCLUDE FROM COVERAGE A SERVICE BY A HEALTH CARE PROVIDER WHERE THE PROVIDER IS NOT OTHERWISE COVERED UNDER THE ENROLLEE CONTRACT. A HEALTH MAINTENANCE ORGANIZATION MAY SUBJECT THE COVERAGE OF A SERVICE DELIVERED VIA TELEHEALTH TO CO-PAYMENTS, COINSU- RANCE OR DEDUCTIBLES PROVIDED THAT THEY ARE AT LEAST AS FAVORABLE TO THE ENROLLEE AS THOSE ESTABLISHED FOR THE SAME SERVICE WHEN NOT DELIVERED VIA TELEHEALTH. A HEALTH MAINTENANCE ORGANIZATION MAY SUBJECT THE COVER- AGE OF A SERVICE DELIVERED VIA TELEHEALTH TO REASONABLE UTILIZATION
MANAGEMENT AND QUALITY ASSURANCE REQUIREMENTS THAT ARE CONSISTENT WITH THOSE ESTABLISHED FOR THE SAME SERVICE WHEN NOT DELIVERED VIA TELE- HEALTH. 2. FOR PURPOSES OF THIS SECTION, "TELEHEALTH" MEANS THE USE OF ELEC- TRONIC INFORMATION AND COMMUNICATION TECHNOLOGIES BY A HEALTH CARE PROVIDER TO DELIVER HEALTH CARE SERVICES TO AN ENROLLEE WHILE SUCH ENROLLEE IS LOCATED AT A SITE THAT IS DIFFERENT FROM THE SITE WHERE THE HEALTH CARE PROVIDER IS LOCATED. S 10. Subdivision 2 of section 367-u of the social services law, as added by chapter 550 of the laws of 2014, is amended to read as follows: 2. Subject to FEDERAL FINANCIAL PARTICIPATION AND the approval of the director of the budget, the commissioner shall not exclude from the payment of medical assistance funds the [provision] DELIVERY of [medical care] HEALTH CARE SERVICES through [telemedicine services] TELEHEALTH, as defined in [section two] SUBDIVISION FOUR OF SECTION TWO THOUSAND NINE HUNDRED NINETY-NINE-CC of the public health law[, provided that such]. SUCH services SHALL meet the requirements of federal law, rules and regulations for the provision of medical assistance pursuant to this title[, and for telehealth services, as defined by section two of the public health law, that are, at a minimum, those required to be provided pursuant to subdivision three-c of section thirty-six hundred fourteen of the public health law]. S 11. Section 7 of chapter 550 of the laws of 2014, amending the public health law, the insurance law and the social services law, relat- ing to the telehealth delivery of services, is amended to read as follows: S 7. This act shall take effect January 1, [2015 and shall apply to all policies and contracts issued, renewed, modified, altered or amended on or after such date] 2016. S 12. This act shall take effect immediately, provided that sections one through ten of this act shall take effect on the same date and in the same manner as chapter 550 of the laws of 2014, takes effect, provided, however, that sections four, eight and nine of this act shall apply to all policies and contracts issued, renewed, modified, altered or amended on or after January 1, 2016, and provided further that, effective immediately, the commissioner of health is authorized to issue, amend or repeal any regulations as necessary to implement this act on or before such effective date.

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