Senate Bill S1234

2023-2024 Legislative Session

Requires certain health insurance policies to include coverage for the cost of certain infant and baby formulas

download bill text pdf

Sponsored By

Current Bill Status - In Senate Committee Insurance 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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2023-S1234 (ACTIVE) - Details

See Assembly Version of this Bill:
A1500
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221, 4303 & 4322, Ins L
Versions Introduced in Other Legislative Sessions:
2009-2010: S8326, A10450
2011-2012: S3270, A4492
2013-2014: S3321, A5282
2015-2016: S2043, A3732
2017-2018: S3345, A6206, A10576
2019-2020: S2305, A5053
2021-2022: S3386, A1831

2023-S1234 (ACTIVE) - Summary

Requires certain health insurance policies to include coverage for the cost of certain infant and baby formulas.

2023-S1234 (ACTIVE) - Sponsor Memo

2023-S1234 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1234
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 10, 2023
                                ___________
 
 Introduced  by  Sen.  BAILEY -- 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  requiring  certain
   health  insurance policies to include coverage for the cost of certain
   infant and baby formulas

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  21  of  subsection  (i) of section 3216 of the
 insurance law, as amended by section 6 of subpart B of part J of chapter
 57 of the laws of 2019, is amended to read as follows:
   (21) Every policy that provides coverage for prescription drugs  shall
 include  coverage  for the cost of enteral, INFANT AND BABY formulas for
 home use, whether administered orally or via tube feeding, for  which  a
 physician  or  other licensed health care provider legally authorized to
 prescribe under title eight of the education law has  issued  a  written
 order.  Such written order shall state that the enteral, INFANT AND BABY
 formula is clearly medically necessary and has been proven effective  as
 a  disease-specific  treatment  regimen. Specific diseases and disorders
 for which enteral, INFANT AND BABY formulas have been  proven  effective
 shall  include, but are not limited to, inherited diseases of amino acid
 or organic acid metabolism; Crohn's  Disease;  gastroesophageal  reflux;
 disorders  of gastrointestinal motility such as chronic intestinal pseu-
 do-obstruction; and multiple, severe food allergies including,  but  not
 limited  to  immunoglobulin E and nonimmunoglobulin E-mediated allergies
 to multiple food proteins; severe  food  protein  induced  enterocolitis
 syndrome;  eosinophilic  disorders; and impaired absorption of nutrients
 caused by disorders affecting the absorptive surface, function,  length,
 and  motility  of  the  gastrointestinal tract. Enteral, INFANT AND BABY
 formulas that are medically necessary and taken under written order from
 a physician for the treatment of  specific  diseases  shall  be  distin-
 guished  from  nutritional  supplements  taken  electively. Coverage for
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02931-01-3
              

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