Bill S541-2013

Requires health insurers to provide coverage for long term medical care for Lyme disease and other tick borne related pathogens

Requires health insurers to provide coverage for long term medical care for Lyme disease and other tick borne related pathogens.

Details

Actions

  • Jan 8, 2014: REFERRED TO INSURANCE
  • Jan 9, 2013: REFERRED TO INSURANCE

Memo

BILL NUMBER:S541

TITLE OF BILL: An act to amend the insurance law and the workers' compensation law, in relation to coverage of long term medical care for Lyme disease and other tick borne related pathogens

PURPOSE OR GENERAL IDEA OF BILL: To require health insurers to provide coverage for long term medical care for Lyme disease and other tick borne related pathogens.

SUMMARY OF SPECIFIC PROVISIONS: This bill will amend subsection (1) of section 3216 of the insurance law by adding a new paragraph 30; amend subsection (1) of section 3221 of the insurance law by adding a new paragraph 19; amend section 4303 of the insurance law by adding a new subsection (jj); paragraph 30 of subdivision 2 of section 3 of the workers' compensation law, as renumbered by chapter 665 of the laws of 1971, is renumbered paragraph 31 and a new paragraph 30 is added; amend closing paragraph of subdivision 2 of section 3 of the workers' compensation law; amend subdivision 9 of section 201 of the workers' compensation law by adding a new paragraph C.

JUSTIFICATION: Current law does not specifically stipulate that Lyme Disease and other tick borne related pathogens be covered under individual and group health insurance policies or workers' compensation. This bill would require this disease to be covered under the aforementioned insurance policies. The bill also specifically states that long term treatments of the disease be covered if so recommended by a physician licensed to practice in New York State.

Lyme Disease strikes many New Yorkers each year. This bill ensures that their pain and suffering is not complicated by a lack of medical coverage, including long term coverage, for care of the disease.

PRIOR LEGISLATIVE HISTORY: 2011-12: S.5354/S.7696 Referred to Insurance 2009-10: A.2100 Held for Consideration in Insurance 2007-08: A.1041 Held for Consideration in Insurance 2005-06: A.385A Held for Consideration in Insurance 2003-04: A.1914A Held for Consideration in Insurance 2001-02: A.9735 Held for Consideration in Insurance

FISCAL IMPLICATIONS: To be determined.

EFFECTIVE DATE: This act shall take effect on the one hundred twentieth day after it shall have become law provided, however, that effective immediately, the addition, amendment and/or repeal of any rules or regulations necessary for the implementation of the foregoing sections of this act on its effective date is authorized and directed to be made and completed on or before such date.


Text

STATE OF NEW YORK ________________________________________________________________________ 541 2013-2014 Regular Sessions IN SENATE (PREFILED) January 9, 2013 ___________
Introduced by Sen. KENNEDY -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance AN ACT to amend the insurance law and the workers' compensation law, in relation to coverage of long term medical care for Lyme disease and other tick borne related pathogens 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) EVERY INSURER ISSUING A POLICY OF ACCIDENT AND HEALTH INSURANCE FOR DELIVERY IN THIS STATE SHALL PROVIDE COVERAGE FOR ALL COSTS FOR TREATMENT OF LYME DISEASE (LYME BORRELIOSIS) AND OTHER TICK BORNE RELATED PATHOGENS. SUCH TREATMENT SHALL INCLUDE NOT LESS THAN THIRTY DAYS OF INTRAVENOUS ANTIBIOTIC THERAPY, SIXTY DAYS OF ORAL ANTIBIOTIC THERAPY, OR BOTH, AND SHALL PROVIDE FURTHER TREATMENT IF RECOMMENDED BY A PHYSICIAN LICENSED TO PRACTICE MEDICINE IN THE STATE OF NEW YORK. S 2. Subsection (l) of section 3221 of the insurance law is amended by adding a new paragraph 19 to read as follows: (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 ALL COSTS FOR TREATMENT OF LYME DISEASE (LYME BORRELIOSIS) AND OTHER TICK BORNE RELATED PATHOGENS. SUCH TREATMENT SHALL INCLUDE NOT LESS THAN THIRTY DAYS OF INTRAVENOUS ANTIBIOTIC THERA- PY, SIXTY DAYS OF ORAL ANTIBIOTIC THERAPY, OR BOTH, AND SHALL PROVIDE FURTHER TREATMENT IF RECOMMENDED BY A PHYSICIAN LICENSED TO PRACTICE MEDICINE IN THE STATE OF NEW YORK. S 3. Section 4303 of the insurance law is amended by adding a new subsection (jj) to read as follows: (JJ) EVERY MEDICAL EXPENSE INDEMNITY CORPORATION, HOSPITAL SERVICE CORPORATION AND HEALTH SERVICE CORPORATION WHICH PROVIDES COVERAGE FOR
MEDICAL, SURGICAL OR MAJOR MEDICAL CARE SHALL PROVIDE COVERAGE FOR ALL COSTS FOR TREATMENT OF LYME DISEASE (LYME BORRELIOSIS) AND OTHER TICK BORNE RELATED PATHOGENS. SUCH TREATMENT SHALL INCLUDE NOT LESS THAN THIRTY DAYS OF INTRAVENOUS ANTIBIOTIC THERAPY, SIXTY DAYS OF ORAL ANTI- BIOTIC THERAPY, OR BOTH, AND SHALL PROVIDE FURTHER TREATMENT IF RECOM- MENDED BY A PHYSICIAN LICENSED TO PRACTICE MEDICINE IN THE STATE OF NEW YORK. S 4. Paragraph 30 of subdivision 2 of section 3 of the workers' compensation law, as renumbered by chapter 665 of the laws of 1971, is renumbered paragraph 31 and a new paragraph 30 is added to read as follows: 30. LYME DISEASE 30. ANY PROCESS INVOLVING (LYME BORRELIOSIS) OUTDOOR ACTIVITY OR AND OTHER TICK BORNE TREATMENT OF ANIMALS. RELATED PATHOGENS. S 5. The closing paragraph of subdivision 2 of section 3 of the work- ers' compensation law, as amended by chapter 666 of the laws of 1971, is amended to read as follows: Nothing in paragraph [thirty] THIRTY-ONE of this subdivision shall be construed to apply to any disability or death due to any disease described in paragraph twenty-nine of this subdivision. S 6. Subdivision 9 of section 201 of the workers' compensation law is amended by adding a new paragraph C to read as follows: C. "DISABILITY" ALSO INCLUDES DISABILITY CAUSED BY OR IN CONNECTION WITH LYME DISEASE (LYME BORRELIOSIS) AND OTHER TICK BORNE RELATED PATHO- GENS. S 7. This act shall take effect on the one hundred twentieth day after it shall have become a law provided, however, that effective immediate- ly, the addition, amendment and/or repeal of any rules or regulations necessary for the implementation of this act on its effective date is authorized to be made on or before such effective date.

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