Requires that medicaid and health insurance plans provide coverage for costs of prescription smoking cessation treatment that is ordered by a physician; establishes a coverage limit of $400 for each covered individual.
TITLE OF BILL: An act to amend the insurance law, in relation to coverage for treatment of smoking cessation
PURPOSE: To extend health insurance coverage to individuals for whom a physician prescribes or orders smoking cessation treatment.
SUMMARY OF PROVISIONS:
Section 1 amends Section 4303 of the Insurance Law by adding a new subsection (1-1) requiring hospital or health service corporations to provide up to $400 worth of coverage for smoking cessation treatment ordered by a physician.
Section 2 amends subsection (i) of Section 3216 of the Insurance Law by adding a new paragraph (30) which requires insurance policies to provide up to $400 of coverage for smoking cessation treatment recommended or prescribed by a physician.
Section 3 amends subsection (1) of Section 3221 of the Insurance Law by adding a new paragraph 19 requiring every group or blanket policy in New York State providing hospital, surgical or medical coverage to include up to $400 of coverage for smoking cessation treatment recommended or prescribed by a physician.
JUSTIFICATION: Tobacco addiction is one of the costliest and most easily avoidable public health problems, requiring Americans and their families to spend millions of dollars every year for the illnesses that are caused by smoking. There are smoking cessation programs that currently are available, however, these highly effective programs are not always covered by either state or private health insurers. Smoking cessation programs are relatively inexpensive when compared to the costly treatments required for victims of smoking-related illnesses. This legislation is necessary for smokers who wish to quit but cannot afford to pay all the expenses of such programs on their own. In addition, smoking cessation programs should be made more accessible to those who wish to quit smoking, particularly in light of the recent tax increases on cigarettes in New York State. As the price of cigarettes continues to rise, more people will want to stop smoking. Including insurance coverage for smoking cessation programs will make the goal of quitting smoking easier, increase public health and reduce the high expense of treating smoking related illnesses later in life.
FISCAL IMPLICATIONS: To be determined. It is expected that the costs of providing coverage required by this bill to be more than offset by the savings to families and state insurance programs in hospital and medical costs.
EFFECTIVE DATE: This act shall take effect on the 180th day after it shall become a law and shall apply to all policies and contracts issued, renewed, modified or amended after such date.
STATE OF NEW YORK ________________________________________________________________________ 3132 2013-2014 Regular Sessions IN SENATE January 30, 2013 ___________Introduced by Sen. KRUEGER -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law, in relation to coverage for treatment of smoking cessation THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 4303 of the insurance law is amended by adding a new subsection (l-1) to read as follows: (L-1) A HOSPITAL SERVICE CORPORATION OR A HEALTH SERVICE CORPORATION WHICH PROVIDES GROUP, GROUP REMITTANCE OR SCHOOL BLANKET COVERAGE FOR INPATIENT HOSPITAL CARE SHALL PROVIDE COVERAGE FOR COSTS OF PRESCRIPTION SMOKING CESSATION TREATMENT THAT IS ORDERED BY A PHYSICIAN. SUCH TREAT- MENT MAY BE LIMITED TO FOUR HUNDRED DOLLARS PER YEAR FOR EACH COVERED INDIVIDUAL. THIS PROVISION SHALL NOT APPLY TO A CONTRACT ISSUED PURSUANT TO SECTION FOUR THOUSAND THREE HUNDRED FIVE OF THIS ARTICLE WHICH COVERS PERSONS EMPLOYED IN MORE THAN ONE STATE OR THE BENEFIT STRUCTURE OF WHICH WAS THE SUBJECT OF COLLECTIVE BARGAINING AFFECTING PERSONS WHO ARE EMPLOYED IN MORE THAN ONE STATE. SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND CO-INSURANCE AS MAY BE DEEMED APPROPRIATE BY THE SUPER- INTENDENT AND ARE CONSISTENT WITH THOSE IMPOSED ON OTHER BENEFITS WITHIN A GIVEN POLICY. SUCH COVERAGE SHALL NOT REPLACE, RESTRICT OR ELIMINATE EXISTING COVERAGE PROVIDED BY THE POLICY. S 2. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 30 to read as follows: (30) EVERY POLICY SHALL PROVIDE COVERAGE FOR COSTS OF PRESCRIPTION SMOKING CESSATION TREATMENT THAT IS ORDERED BY A PHYSICIAN. SUCH COVER- AGE MAY BE LIMITED TO FOUR HUNDRED DOLLARS PER YEAR FOR EACH COVERED INDIVIDUAL. S 3. Subsection (1) of section 3221 of the insurance law is amended by adding a new paragraph 19 to read as follows:EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD01001-01-3 S. 3132 2
(19) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH PROVIDES HOSPITAL, SURGICAL OR MEDICAL COVERAGE SHALL PROVIDE COVERAGE FOR COSTS OF PRESCRIPTION SMOKING CESSATION TREATMENT THAT IS ORDERED BY A PHYSICIAN. SUCH COVERAGE MAY BE LIMITED TO FOUR HUNDRED DOLLARS FOR EACH COVERED INDIVIDUAL. S 4. This act shall take effect on the one hundred eightieth day after it shall have become a law and shall apply to all policies and contracts issued, renewed, modified, altered or amended on or after such date; except that any rules and regulations necessary to implement the provisions of this act are authorized and directed to be promulgated, amended or repealed on or before such effective date.