New York S 965: Relates to additional damages recoverable for the use of a deadly weapon

Bill Text

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S00965 Summary:

BILL NOS00965 

&nbsp

SAME ASSAME AS A02384

&nbsp

SPONSORHOYLMAN-SIGAL

&nbsp

COSPNSRADDABBO, ASHBY, CLEARE, COMRIE, FERNANDEZ, JACKSON, MARTINS, MAY, SALAZAR, SUTTON, WEBB, WEBER

&nbsp

MLTSPNSR

&nbsp

Amd §§3216, 3221 & 4303, Ins L; add §4406-j, Pub Health L

&nbsp

Requires insurers to provide insurance coverage for treatment of rare diseases, life-threatening conditions or diseases, degenerative and disabling conditions, or diagnoses involving medically fragile children, by a provider of the patient's choice.

Go to top S00965 Actions:

BILL NOS00965 

&nbsp

01/08/2025REFERRED TO INSURANCE

Go to topS00965 Committee&nbspVotes:

Go to topS00965 Floor&nbspVotes:

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

Go to topS00965 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 965

 2025-2026 Regular Sessions

 IN SENATE

 (Prefiled)

 January 8, 2025
 ___________

 Introduced by Sens. HOYLMAN-SIGAL, SALAZAR -- read twice and ordered
 printed, and when printed to be committed to the Committee on Insur-
 ance

 AN ACT to amend the insurance law and the public health law, in relation
 to providing insurance coverage for rare diseases, life-threatening
 conditions or diseases, degenerative and disabling conditions, or
 diagnoses involving medically fragile children

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

 1 Section 1. Subsection (i) of section 3216 of the insurance law is
 2 amended by adding a new paragraph 40 to read as follows:
 3 (40) (A) Every policy which provides hospital, surgical, medical or
 4 major medical coverage shall provide coverage for medically necessary
 5 services from a chosen provider for a confirmed diagnosis that is deemed
 6 to be a rare disease, life-threatening condition or disease, degenera-
 7 tive and disabling condition, or involves a medically fragile child,
 8 with no restriction to a plan network, if the following conditions are
 9 met:
 10 (i) (A) The costs of the chosen provider are equal to or less than the
 11 average cost that would have otherwise been paid to a local network
 12 provider who possesses a similar subspecialty as such chosen provider;
 13 and
 14 (B) the patient's treating specialist or primary care provider
 15 provides a written statement to recommend the chosen provider for the
 16 particular disease.
 17 (ii) The chosen provider or the patient's primary care physician
 18 provides advance notice to such patient's network plan prior to a
 19 planned procedure covered pursuant to this paragraph.
 20 (iii) The chosen provider is accredited or designated by the depart-
 21 ment of health, the federal government, or a voluntary national health

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD02918-01-5

 S. 965 2

 1 organization as having special expertise in treating, or has demon-
 2 strated a clinical focus in the area of, the confirmed diagnosis for
 3 which coverage is sought pursuant to this paragraph. Provided however,
 4 that nothing in this paragraph shall require such chosen provider to be
 5 participating in the patient's network or located within the state;
 6 provided further that nothing herein shall obligate to cover cost
 7 related to travel to the chosen provider.
 8 (B) For the purposes of this paragraph, the following terms shall have
 9 the following meanings:
 10 (i) "Rare disease" shall have the same meaning as set forth in subdi-
 11 vision seven-g of section forty-nine hundred of the public health law.
 12 (ii) "Life-threatening condition or disease" shall have the same mean-
 13 ing as set forth in subdivision seven-a of section forty-nine hundred of
 14 the public health law.
 15 (iii) "Degenerative and disabling condition" shall mean a condition or
 16 disease which (a) requires specialized medical care over a prolonged
 17 period of time, or (b) qualifies the patient as a disabled person, as
 18 defined by subdivision five of section two hundred eight of the social
 19 services law.
 20 (iv) "Medically fragile child" shall have the same meaning as set
 21 forth in subdivision nine of section forty-four hundred one of