New York S 760: Relates to requiring insurance coverage for epinephrine auto-injectors

Bill Text

STATE OF NEW YORK
________________________________________________________________________
760
2025-2026 Regular Sessions
IN SENATE
(Prefiled)
January 8, 2025
___________
Introduced by Sen. RIVERA -- read twice and ordered printed, and when
printed to be committed to the Committee on Rules
AN ACT to amend the insurance law, in relation to requiring health
insurance plans to provide coverage for epinephrine auto-injector
devices
The People of the State of New York, represented in Senate and Assem-
bly, do enact as follows:
1 Section 1. Subparagraph (A) of paragraph 39 of subsection (i) of
2 section 3216 of the insurance law, as added by a chapter of the laws of
3 2024 amending the insurance law relating to requiring health insurance
4 plans to provide coverage for epinephrine auto-injector devices, as
5 proposed in legislative bills numbers S. 7114-A and A. 6425-A, is
6 amended to read as follows:
7 (A) Every insurer issuing a policy of accident and health insurance
8 delivered or issued for delivery in this state which provides major
9 medical or similar comprehensive-type coverage and provides coverage for
10 shall include coverage for[ ]prescription drugs , at a minimum, two
11 medically necessary epinephrine auto-injector devices for the emergency
12 treatment of life-threatening allergic reactions. Such coverage may be
13 subject to annual deductibles and coinsurance as may be deemed appro-
14 priate by the superintendent [and as are consistent with those estab-
15 ]; provided however, thelished for other benefits within a given policy
16 total amount that [ ] is required to pay out-a covered person an insured
17 of-pocket for such devices shall be capped at an amount not to exceed
18 one hundred dollars annually regardless of the insured's deductible,
19 copayment, coinsurance or any other cost-sharing requirement. If under
20 federal law, application of [ ] wouldthis requirement the annual cap
21 result in health savings account ineligibility under 26 USC 223, [this
22 requirement shall apply for health savings account-qualified high
23 deductible health plans with respect to the deductible of such a plan
EXPLANATION--Matter in (underscored) is new; matter in bracketsitalics
[ ] is old law to be omitted.
LBD02836-01-5

S. 760 2
1 after the enrollee has satisfied the minimum deductible under 26 USC
2 ] ,223 such coverage may be subject to the plan's annual deductible
3 except for with respect to items or services that are preventive
4 care pursuant to 26 USC 223(c)(2)(C), in which case the require-
5 ments of this paragraph shall apply regardless of whether the minimum
6 deductible under 26 USC 223 has been satisfied.
7 § 2. Subparagraph (A) of paragraph 23 of subsection (k) of section
8 3221 of the insurance law, as added by a chapter of the laws of 2024
9 amending the insurance law relating to requiring health insurance plans
10 to provide coverage for epinephrine auto-injector devices, as proposed
11 in legislative bills numbers S. 7114-A and A. 6425-A, is amended to read
12 as follows:
13 (A) Every group or blanket policy of accident and health insurance
14 delivered or issued for delivery in this state which provides [medical
15 coverage that includes coverage for physician services in a physician's
16 ] major medical or similar compre-office and every policy which provides
17 hensive-type coverage shalland provides coverage for prescription drugs
18 provide coverage for[ ] medically necessary epineph-, at a minimum, two
19 rine auto-injector devices for the emergency treatment of life-threaten-
20 ing allergic reactions. Such coverage may be subject to annual deduct-
21 ibles and coinsurance as may be deemed appropriate by the superintendent
22 [and as are consistent with those established for other benefits within
23 ]; provided however, the total amount that [a given policy a covered
24 ] is required to pay out-of-pocket for such devicesperson an insured
25 shall be capped at an amount not to exceed one hundred dollars annually
26 regardless of the insured's deductible, copayment, coinsurance or any
27 other cost-sharing requirement. If under federal law, application
28 of [ ] would result in health savingsthis requirement the annual cap
29 account ineligibility under 26 USC 223, [this requirement shall
30 apply for health savings account-qualified high deductible
31 health plans with respect to the deductible of such a plan after the
32 ]enrollee has satisfied the minimum deductible under 26 USC 223
33 , exceptsuch coverage may be subject to the plan's annual deductible
34 for with respect to items or services that are preventive care pursu-
35 ant to 26 USC 223(c)(2)(C), in which case the requirements of this
36 paragraph shall apply regardless of whether the minimum deductible
37 under 26 USC 223 has been satisfied.
38 § 3. Paragraph 1 of subsection (vv) of section 4303 of the insurance
39 law, as added by a chapter of the laws of 2024 amending the insurance
40 law relating to requiring heal