New York A 3903: Relates to including certain out of home services such as transition from a hospital, nursing facility or other institutional setting to the home within home care insurance coverage

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A03903 Summary:

BILL NOA03903 

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SAME ASNo Same As

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SPONSORSimon

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COSPNSR

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MLTSPNSR

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Amd §§3221 & 4303, Ins L

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Includes certain out of home services such as transition from a hospital, nursing facility or other institutional setting to the home within home care insurance coverage.

Go to top A03903 Actions:

BILL NOA03903 

&nbsp

01/30/2025referred to insurance

01/07/2026referred to insurance

Go to topA03903 Committee&nbspVotes:

Go to topA03903 Floor&nbspVotes:

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

Go to topA03903 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 3903

 2025-2026 Regular Sessions

 IN ASSEMBLY

 January 30, 2025
 ___________

 Introduced by M. of A. SIMON -- read once and referred to the Committee
 on Insurance

 AN ACT to amend the insurance law, in relation to including certain out
 of home services such as transition from a hospital, nursing facility
 or other institutional setting to the home within home care insurance
 coverage

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

 1 Section 1. Subparagraphs (C), (D) and (E) of paragraph 1 of subsection
 2 (k) of section 3221 of the insurance law, subparagraphs (C) and (D) as
 3 amended by chapter 557 of the laws of 2000, are amended to read as
 4 follows:
 5 (C) Home care means the care and treatment of a covered person who is
 6 under the care of a physician [but only if] and who requires the
 7 services of an agency described in subparagraph (D) of this paragraph
 8 for: transition of the covered person from hospital, nursing facility or
 9 other institutional setting to home; rehabilitation, recovery or medical
 10 management of the covered person at home following hospitalization or
 11 following care in a nursing facility or other institutional setting; or
 12 medical management of a condition predisposing the covered individual to
 13 hospitalization [or], confinement in a nursing facility [as defined in
 14 subchapter XVIII of the federal Social Security Act, 42 U.S.C. §§ 1395
 15 et seq, would otherwise have been required] or the need for other out-
 16 of-home services otherwise covered under the contract if home care [was]
 17 is not provided, and the plan covering the home health service is estab-
 18 lished and approved in writing by such physician.
 19 (D) Home care shall be provided by an agency possessing a valid
 20 certificate of approval or license issued pursuant to article thirty-six
 21 of the public health law and shall consist of one or more of the follow-
 22 ing:

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD06580-01-5

 A. 3903 2

 1 (i) Part-time or intermittent home nursing care by or under the super-
 2 vision of a registered professional nurse (R.N.).
 3 (ii) Part-time or intermittent home health aide services which consist
 4 primarily of caring for the patient.
 5 (iii) Physical, occupational or speech therapy, social work, respir-
 6 atory therapy and nutritional counseling, if provided by the home health
 7 service or agency.
 8 (iv) Medical supplies, drugs and medications prescribed by a physi-
 9 cian, and laboratory services by or on behalf of a certified home health
 10 agency or licensed home care services agency to the extent such items
 11 would have been covered under the contract if the covered person had
 12 been hospitalized or confined in a skilled nursing facility as defined
 13 in subchapter XVIII of the federal Social Security Act, 42 U.S.C. §§
 14 1395 et seq.
 15 (E) For the purpose of determining the benefits for home care avail-
 16 able to a covered person, [each visit by a member of a home care team
 17 shall be considered as one home care visit; the contract may contain a
 18 limitation on the number of home care visits, but not less than forty
 19 such visits in any calendar year or in any continuous period of twelve
 20 months, for each person covered under the contract; four hours of home
 21 health aide service shall be considered as one home care visit] nothing
 22 in this paragraph shall be construed to prevent the management or utili-
 23 zation review of home care benefits, including the