Bill Text: NY A00609 | 2025-2026 | General Assembly | Introduced

---

Bill Title: Requires insurers to provide coverage for delivery through store and forward technology; requires prescription drug policies to cover the cost of contraceptive care delivered via telemedicine.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2025-01-08 - referred to insurance [A00609 Detail]

Download: New_York-2025-A00609-Introduced.html

---

                STATE OF NEW YORK
        ________________________________________________________________________

                                           609

                               2025-2026 Regular Sessions

                   IN ASSEMBLY

                                       (Prefiled)

                                     January 8, 2025
                                       ___________

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

        AN ACT to amend the insurance law, the public health law and the  social
          services  law,  in relation to requiring coverage for delivery through
          store and forward technology

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

     1    Section 1. Legislative findings and declaration. The Legislature here-
     2  by  finds  that  there is a serious health concern in insurance policies
     3  denying coverage for contraceptive care. The Legislature also finds that
     4  throughout the COVID-19 pandemic, telemedicine has  been  essential  for
     5  patients across the state to receive care safely.
     6    This  Act  enacts various provisions requiring that insurance policies
     7  cover services provided  through  telemedicine,  including  requirements
     8  that  insurers  provide coverage for contraceptive care, that will allow
     9  patients across the  state  to  receive  care  and  limit  the  risk  of
    10  infection of COVID-19 throughout the pandemic.
    11    § 2. Subsection (a) of section 3217-h of the insurance law, as amended
    12  by  section 3 of part V of chapter 57 of the laws of 2022, is amended to
    13  read as follows:
    14    (a) (1) An insurer shall not exclude from coverage a service  that  is
    15  otherwise  covered  under  a policy that provides comprehensive coverage
    16  for hospital, medical or surgical care, or  prescription  drugs  because
    17  the  service  is  delivered  via telehealth or through store and forward
    18  technology, as [that term is] such terms are defined in  subsection  (b)
    19  of  this  section[;  provided, however, that an insurer may exclude from
    20  coverage a service by a health care provider where the provider  is  not
    21  otherwise  covered  under the policy] and in section twenty-nine hundred
    22  ninety-nine-cc of the public health law.  An  insurer  may  subject  the
    23  coverage  of  a service delivered via telehealth to co-payments, coinsu-

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02419-01-5
        A. 609                              2

     1  rance or deductibles provided that they are at least as favorable to the
     2  insured as those established for the same service when not delivered via
     3  telehealth. An insurer may subject the coverage of a  service  delivered
     4  via  telehealth  to reasonable utilization management and quality assur-
     5  ance requirements that are consistent with  those  established  for  the
     6  same service when not delivered via telehealth.
     7    (2)  An  insurer  that  provides  comprehensive coverage for hospital,
     8  medical or surgical care shall reimburse covered services  delivered  by
     9  means of telehealth on the same basis, at the same rate, and to the same
    10  extent  that  such  services  are  reimbursed  when delivered in person;
    11  provided that reimbursement of covered services delivered via telehealth
    12  shall not require reimbursement of costs not actually  incurred  in  the
    13  provision  of  the telehealth services, including charges related to the
    14  use of a clinic or other facility when neither the originating site  nor
    15  distant site occur within the clinic or other facility.
    16    (3)  An  insurer  that  provides  comprehensive coverage for hospital,
    17  medical, or surgical care with a network of health care providers  shall
    18  ensure  that  such  network  is adequate to meet the telehealth needs of
    19  insured individuals for services covered under the policy when medically
    20  appropriate.
    21    § 2-a. Subsection (a) of section 3217-h of the insurance law, as added
    22  by chapter 6 of the laws of 2015, is amended to read as follows:
    23    (a) An insurer shall not exclude  from  coverage  a  service  that  is
    24  otherwise  covered  under  a policy that provides comprehensive coverage
    25  for hospital, medical or surgical care, or  prescription  drugs  because
    26  the  service  is  delivered  via telehealth or through store and forward
    27  technology, as [that term is] such terms are defined in  subsection  (b)
    28  of  this  section [; provided, however, that an insurer may exclude from
    29  coverage a service by a health care provider where the provider  is  not
    30  otherwise  covered  under the policy] and in section twenty-nine hundred
    31  ninety-nine-cc of the public health law.   An insurer  may  subject  the
    32  coverage  of  a service delivered via telehealth to co-payments, coinsu-
    33  rance or deductibles provided that they are at least as favorable to the
    34  insured as those established for the same service when not delivered via
    35  telehealth. An insurer may subject the coverage of a  service  delivered
    36  via  telehealth  to reasonable utilization management and quality assur-
    37  ance requirements that are consistent with  those  established  for  the
    38  same service when not delivered via telehealth.
    39    § 3. Subsection (i) of section 3216 of the insurance law is amended by
    40  adding a new paragraph 40 to read as follows:
    41    (40) Every policy which provides coverage for prescription drugs shall
    42  include  coverage  for  the cost of contraceptive care delivered through
    43  store and  forward  technology  as  authorized  by  section  twenty-nine
    44  hundred ninety-nine-cc of the public health law.
    45    § 4. Subsection (l) of section 3221 of the insurance law is amended by
    46  adding a new paragraph 23 to read as follows:
    47    (23) Every policy which provides coverage for prescription drugs shall
    48  include  coverage  for  the cost of contraceptive care delivered through
    49  store and forward technology  in  accordance  with  section  twenty-nine
    50  hundred ninety-nine-cc of the public health law.
    51    §  5.  Section  4303  of  the insurance law is amended by adding a new
    52  subsection (ww) to read as follows:
    53    (ww) Every contract issued by a  hospital  service  corporation  or  a
    54  health  service  corporation  which  provides  coverage for prescription
    55  drugs shall include coverage for the cost of contraceptive  care  deliv-
        A. 609                              3

     1  ered  through  store  and  forward technology as that term is defined in
     2  section twenty-nine hundred ninety-nine-cc of the public health law.
     3    § 6. Subsection (a) of section 4306-g of the insurance law, as amended
     4  by  section 4 of part V of chapter 57 of the laws of 2022, is amended to
     5  read as follows:
     6    (a) (1) A corporation shall not exclude from coverage a  service  that
     7  is otherwise covered under a contract that provides comprehensive cover-
     8  age  for  hospital,  medical  or  surgical  care,  or prescription drugs
     9  because the service is delivered via telehealth[,] or through store  and
    10  forward  technology  as  [that  term  is]  such  terms  are  defined  in
    11  subsection (b) of this section[; provided, however, that  a  corporation
    12  may  exclude from coverage a service by a health care provider where the
    13  provider is not otherwise covered under the  contract]  and  in  section
    14  twenty-nine  hundred  ninety-nine-cc of the public health law.  A corpo-
    15  ration may subject the coverage of a service delivered via telehealth to
    16  co-payments, coinsurance or deductibles provided that they are at  least
    17  as  favorable  to  the insured as those established for the same service
    18  when not delivered via telehealth. A corporation may subject the  cover-
    19  age  of  a  service  delivered  via telehealth to reasonable utilization
    20  management and quality assurance requirements that are  consistent  with
    21  those  established  for  the  same  service when not delivered via tele-
    22  health.
    23    (2) A corporation that provides comprehensive coverage  for  hospital,
    24  medical  or  surgical care shall reimburse covered services delivered by
    25  means of telehealth on the same basis, at the same rate, and to the same
    26  extent that such services  are  reimbursed  when  delivered  in  person;
    27  provided that reimbursement of covered services delivered via telehealth
    28  shall  not  require  reimbursement of costs not actually incurred in the
    29  provision of the telehealth services, including charges related  to  the
    30  use  of a clinic or other facility when neither the originating site nor
    31  the distant site occur within the clinic or other facility.  The  super-
    32  intendent may promulgate regulations to implement the provisions of this
    33  section.
    34    (3)  A  corporation that provides comprehensive coverage for hospital,
    35  medical, or surgical care with a network of health care providers  shall
    36  ensure  that  such  network  is adequate to meet the telehealth needs of
    37  insured individuals for services covered under the policy when medically
    38  appropriate.
    39    § 6-a. Subsection (a) of section 4306-g of the insurance law, as added
    40  by chapter 6 of the laws of 2015, is amended to read as follows:
    41    (a) A corporation shall not exclude from coverage a  service  that  is
    42  otherwise  covered under a contract that provides comprehensive coverage
    43  for hospital, medical or surgical care, or  prescription  drugs  because
    44  the  service is delivered via telehealth[,] or through store and forward
    45  technology as [that term is] such terms are defined in subsection (b) of
    46  this section [; provided, however, that a corporation may  exclude  from
    47  coverage  a  service by a health care provider where the provider is not
    48  otherwise covered under the contract] and in section twenty-nine hundred
    49  ninety-nine-cc of the public health law.  A corporation may subject  the
    50  coverage  of  a service delivered via telehealth to co-payments, coinsu-
    51  rance or deductibles provided that they are at least as favorable to the
    52  insured as those established for the same service when not delivered via
    53  telehealth. A corporation may subject the coverage of a  service  deliv-
    54  ered  via  telehealth  to  reasonable utilization management and quality
    55  assurance requirements that are consistent with  those  established  for
    56  the same service when not delivered via telehealth.
        A. 609                              4

     1    §  7.  Subdivision  6  of section 2999-cc of the public health law, as
     2  added by chapter 6 of the laws of 2015, is amended to read as follows:
     3    6.  "Store  and forward technology" means the asynchronous, electronic
     4  transmission of a patient's health information [in the form of  patient-
     5  specific  digital  images and/or pre-recorded videos from a provider at]
     6  from an originating site to a telehealth provider at a distant site.
     7    § 8. Subdivision 2 of section 365-a of  the  social  services  law  is
     8  amended by adding a new paragraph (nn) to read as follows:
     9    (nn)  care  and services provided by a telehealth provider pursuant to
    10  section twenty-nine hundred ninety-nine-cc of the public health law.
    11    § 9. This act shall take effect immediately; provided that the  amend-
    12  ments  to  subsection (a) of section 3217-h of the insurance law made by
    13  section two of this act shall be subject to the expiration and reversion
    14  of such subdivision pursuant to section 7 of part V of chapter 57 of the
    15  laws of 2022, as amended, when upon such date the provisions of  section
    16  two-a  of  this act shall take effect; provided, further, the amendments
    17  to subsection (a) of section 4306-g of the insurance law made by section
    18  six of this act shall be subject to the expiration and reversion of such
    19  subsection pursuant to section 7 of part V of chapter 57 of the laws  of
    20  2022, as amended, when upon such date the provisions of section six-a of
    21  this act shall take effect.