New York A 11342: Enacts the "Give Kids a Chance - Carter and Ray's Law"; mandates health insurance coverage for congenital anomalies

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A11342 Summary:

BILL NOA11342 

&nbsp

SAME ASSAME AS S09649-A

&nbsp

SPONSORRules (Simon)

&nbsp

COSPNSR

&nbsp

MLTSPNSR

&nbsp

Amd §§3216, 4235, 4304 & 4305, Ins L

&nbsp

Enacts the "Give Kids a Chance - Carter and Ray's Law" mandating health insurance coverage for congenital anomalies including certain reconstructive services, habilitative services, and inpatient and outpatient services.

Go to top A11342 Actions:

BILL NOA11342 

&nbsp

05/11/2026referred to insurance

Go to topA11342 Committee&nbspVotes:

Go to topA11342 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topA11342 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 11342

 IN ASSEMBLY

 May 11, 2026
 ___________

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

 AN ACT to amend the insurance law, in relation to enacting the "Give
 Kids a Chance - Carter and Ray's Law" mandating health insurance
 coverage for congenital anomalies

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Short title. This act shall be known and may be cited as
 2 the "Give Kids a Chance - Carter and Ray's Law".
 3 § 2. Subsection (a) of section 3216 of the insurance law is amended by
 4 adding five new paragraphs 5, 6, 7, 8 and 9 to read as follows:
 5 (5) "Congenital anomaly" means a medically diagnosed condition exist-
 6 ing at or from birth that is a deviation from the common structure or
 7 function of the body, whether caused by a hereditary or developmental
 8 disability or disease.
 9 (6) "Cosmetic surgery" means surgical and nonsurgical elective proce-
 10 dures that enhance and reshape structures of the body to improve appear-
 11 ance and confidence, but are not necessary to improve body structure or
 12 function.
 13 (7) "Habilitative services" means healthcare services that help an
 14 individual keep, learn, or improve skills and functioning for daily
 15 living. Habilitative services shall include but is not limited to phys-
 16 ical and occupational therapy, speech-language pathology, and services
 17 for people with disabilities in a variety of inpatient and/or outpatient
 18 settings.
 19 (8) "Reconstructive services" means procedures or surgery that are
 20 performed to treat structures of the body affected aesthetically or
 21 functionally by congenital anomalies, developmental abnormalities, trau-
 22 ma, infection, tumors, or disease. Reconstructive services are intended
 23 to improve function and ability, and may also be performed to achieve a
 24 more typical appearance of the affected structure.
 25 (9) "Deviation" means an anomaly that impairs the function of the body
 26 and includes but is not limited to the conditions of cleft lip, cleft
 27 palate, webbed fingers or toes, supernumerary toes or fingers, craniofa-

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD06189-03-6

 A. 11342 2

 1 cial malformations, disorders of metabolism, and other conditions that
 2 are medically diagnosed to be congenital anomalies.
 3 § 3. Paragraph 4 of subsection (c) of section 3216 of the insurance
 4 law is amended by adding a new subparagraph (D) to read as follows:
 5 (D) (1) For the purpose of this subparagraph, the term "treatment"
 6 includes inpatient and outpatient care and services performed to improve
 7 or restore body function, or performed to approximate a normal appear-
 8 ance, as a result of a congenital anomaly and shall not include cosmetic
 9 surgery. Inpatient and outpatient care and services shall include treat-
 10 ment to any and all missing or abnormal body parts, including teeth, the
 11 oral cavity, and their associated structures, that would otherwise be
 12 provided under the plan or coverage for any other injury and sickness,
 13 including:
 14 (i) All inpatient and outpatient reconstructive services and proce-
 15 dures;
 16 (ii) All services, procedures, and adjunctive needs, including but not
 17 limited to prosthetics and appliances, resulting from complications;
 18 (iii) Adjunctive dental, orthodontic or prosthodontic support from
 19 birth until the medical or surgical t