S T A T E   O F   N E W   Y O R K
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                                  11432

                          I N  A S S E M B L Y

                              June 14, 2010
                               ___________

Introduced  by  COMMITTEE  ON  RULES  --  (at request of M. of A. Ortiz,
  Schroeder) -- read once and referred to the Committee on Insurance

AN ACT to amend the insurance  law,  in  relation  to  requiring  health
  insurance  policies  to  provide coverage for medically necessary care
  for the treatment of autism spectrum disorder

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

  Section  1.  Paragraph  25  of  subsection  (i) of section 3216 of the
insurance law, as added by chapter 557 of the laws of 2006,  is  amended
to read as follows:
  (25)  (A) Every policy which provides coverage for hospital, surgical,
or medical care coverage shall not exclude coverage  for  diagnosis  and
treatment  of  medical conditions otherwise covered by the policy solely
because the treatment is provided to diagnose or treat  autism  spectrum
disorder. For purposes of this section, "autism spectrum disorder" means
a  neurobiological  condition  that  includes autism, Asperger syndrome,
Rett's syndrome, or pervasive developmental disorder.
  (B) EVERY POLICY WHICH PROVIDES COVERAGE FOR  HOSPITAL,  SURGICAL,  OR
MEDICAL  CARE  COVERAGE  SHALL PROVIDE ANY AND ALL DIAGNOSTIC SCREENING,
TESTS, AND ASSESSMENTS AND TREATMENT INCLUDING MEDICAL  CARE,  CONSULTA-
TION, HABILITATION, REHABILITATION, SPEECH, BEHAVIORAL, OCCUPATIONAL AND
PHYSICAL THERAPIES, PEDIATRIC, NEUROLOGICAL, GASTRO-ENTEROLOGIC, AND ANY
OTHER  MEDICALLY  NECESSARY CARE THAT IS PROVIDED BY A LICENSED PROVIDER
REQUIRED FOR  THE  TREATMENT  OF  AUTISM  SPECTRUM  DISORDER,  INCLUDING
ASPERGER'S  DISORDER AND PERVASIVE DEVELOPMENTAL DISORDERS AS DETERMINED
BY THE TREATING PHYSICIAN.
  S 2. Paragraph 17 of subsection (1) of section 3221 of  the  insurance
law,  as added by chapter 557 of the laws of 2006, is amended to read as
follows:
  (17) (A) A group or blanket accident or  health  insurance  policy  or
issuing  a  group  or  blanket  policy  for delivery in this state which
provides coverage for hospital, surgical, or medical care coverage shall
not exclude coverage for diagnosis and treatment of  medical  conditions
otherwise  covered  by  the  policy because the treatment is provided to

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

                                                           LBD17494-01-0

A. 11432                            2

diagnose or  treat  autism  spectrum  disorder.  For  purposes  of  this
section,  "autism  spectrum  disorder" means a neurobiological condition
that includes autism, Asperger syndrome, Rett's syndrome,  or  pervasive
developmental disorder.
  (B)  EVERY  POLICY  WHICH PROVIDES COVERAGE FOR HOSPITAL, SURGICAL, OR
MEDICAL CARE COVERAGE SHALL PROVIDE ANY AND  ALL  DIAGNOSTIC  SCREENING,
TESTS,  AND  ASSESSMENTS AND TREATMENT INCLUDING MEDICAL CARE, CONSULTA-
TION, HABILITATION, REHABILITATION, SPEECH, BEHAVIORAL, OCCUPATIONAL AND
PHYSICAL THERAPIES, PEDIATRIC, NEUROLOGICAL, GASTRO-ENTEROLOGIC, AND ANY
OTHER MEDICALLY NECESSARY CARE THAT IS PROVIDED BY A  LICENSED  PROVIDER
REQUIRED  FOR  THE  TREATMENT  OF  AUTISM  SPECTRUM  DISORDER, INCLUDING
ASPERGER'S DISORDER AND PERVASIVE DEVELOPMENTAL DISORDERS AS  DETERMINED
BY THE TREATING PHYSICIAN.
  S 3. Subsection (ee) of section 4303 of the insurance law, as added by
chapter 557 of the laws of 2006, is amended to read as follows:
  (ee)  (1)  A medical expense indemnity corporation, a hospital service
corporation or a health service corporation which provides coverage  for
hospital,  surgical, or medical care coverage shall not exclude coverage
for diagnosis and treatment of medical conditions otherwise  covered  by
the policy solely because the treatment is provided to diagnose or treat
autism spectrum disorder. For purposes of this section, "autism spectrum
disorder" means a neurobiological condition that includes autism, Asper-
ger syndrome, Rett's syndrome, or pervasive developmental disorder.
  (2)  EVERY  POLICY  WHICH PROVIDES COVERAGE FOR HOSPITAL, SURGICAL, OR
MEDICAL CARE COVERAGE SHALL PROVIDE ANY AND  ALL  DIAGNOSTIC  SCREENING,
TESTS,  AND  ASSESSMENTS AND TREATMENT INCLUDING MEDICAL CARE, CONSULTA-
TION, HABILITATION, REHABILITATION, SPEECH, BEHAVIORAL, OCCUPATIONAL AND
PHYSICAL THERAPIES, PEDIATRIC, NEUROLOGICAL, GASTRO-ENTEROLOGIC, AND ANY
OTHER MEDICALLY NECESSARY CARE THAT IS PROVIDED BY A  LICENSED  PROVIDER
REQUIRED  FOR  THE  TREATMENT  OF  AUTISM  SPECTRUM  DISORDER, INCLUDING
ASPERGER'S DISORDER AND PERVASIVE DEVELOPMENTAL DISORDERS AS  DETERMINED
BY THE TREATING PHYSICIAN.
  S  4. This act shall take effect on the first of January next succeed-
ing the date on which it shall have become a law and shall apply to  all
policies  or  contracts issued, renewed, modified, altered or amended on
and after such effective date.