New York S 4961: Provides insurance coverage for cranial prostheses

Bill Text

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S04961 Summary:

BILL NOS04961 

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SAME ASNo Same As

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SPONSORBAILEY

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COSPNSR

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MLTSPNSR

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Amd §§3216, 3221 & 4303, Ins L

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Provides insurance coverage for cranial prostheses for a diagnosed health condition, chronic illness, or injury.

Go to top S04961 Actions:

BILL NOS04961 

&nbsp

02/14/2025REFERRED TO INSURANCE

05/28/2025REPORTED AND COMMITTED TO FINANCE

01/07/2026REFERRED TO INSURANCE

Go to topS04961 Committee&nbspVotes:

Go to topS04961 Floor&nbspVotes:

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

Go to topS04961 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 4961

 2025-2026 Regular Sessions

 IN SENATE

 February 14, 2025
 ___________

 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 providing insurance
 coverage for cranial prostheses

 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 coverage for prostheses shall
 4 provide coverage for cranial prostheses for individuals experiencing
 5 permanent or temporary medical hair loss provided:
 6 (i) a licensed provider prescribes such cranial prosthesis for a
 7 covered person's course of treatment for the diagnosed health condition,
 8 chronic illness, or injury, including, but not limited to, alopecia
 9 areata, alopecia medicamentosa, scarring alopecia, and lupus;
 10 (ii) the policy provides coverage for a cranial prosthesis to a
 11 covered person no more frequently than once every twelve months; and
 12 (iii) the coverage is limited to seven hundred fifty dollars for each
 13 instance of coverage, and shall be subject to any cost-sharing require-
 14 ments that are otherwise applicable.
 15 (B) For purposes of this paragraph, the term "cranial prosthesis"
 16 means a wig or hairpiece.
 17 § 2. Subsection (l) of section 3221 of the insurance law is amended by
 18 adding a new paragraph 23 to read as follows:
 19 (23) (A) Every group or blanket policy delivered or issued for deliv-
 20 ery in this state that provides coverage for protheses shall provide
 21 coverage for cranial prostheses for individuals experiencing permanent
 22 or temporary medical hair loss provided:
 23 (i) a licensed provider prescribes the cranial prosthesis for an
 24 enrollee's course of treatment for the diagnosed health condition,

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD07940-01-5

 S. 4961 2

 1 chronic illness, or injury, including, but not limited to, alopecia
 2 areata, alopecia medicamentosa, scarring alopecia, and lupus;
 3 (ii) the policy provides coverage for a cranial prosthesis to an indi-
 4 vidual enrollee no more frequently than once every twelve months; and
 5 (iii) the coverage is limited to seven hundred fifty dollars for each
 6 instance of coverage, and shall be subject to any cost-sharing require-
 7 ments that are otherwise applicable.
 8 (B) For purposes of this paragraph, the term "cranial prosthesis"
 9 means a wig or hairpiece.
 10 § 3. Section 4303 of the insurance law is amended by adding a new
 11 subsection (ww) to read as follows:
 12 (ww) (1) A hospital service corporation, health service corporation or
 13 medical expense indemnity fund which provides coverage for prostheses
 14 shall provide coverage for cranial prostheses for individuals experienc-
 15 ing permanent or temporary medical hair loss provided:
 16 (A) a licensed provider prescribes the cranial prosthesis for an
 17 enrollee's or subscriber's course of treatment for the diagnosed health
 18 condition, chronic illness, or injury, including, but not limited to,
 19 alopecia areata, alopecia medicamentosa, scarring alopecia, and lupus;
 20 (B) the contract provides coverage for a cranial prosthesis to an
 21 individual enrollee or subscriber no more frequently than once every
 22 twelve months; and
 23 (C) the coverage is limited to seven hundred fifty dollars for each
 24 instance of coverage, and shal