Bill Text: NY A01963 | 2025-2026 | General Assembly | Introduced

---

Bill Title: Provides for universal newborn nurse home visiting services; requires health insurance coverage for universal newborn nurse home visiting services; authorizes the department of health to apply for certain waivers; directs the superintendent of financial services to require an insurer, health carrier or health benefit plan to notify enrollees annually of universal newborn nurse home visiting services.

Spectrum: Partisan Bill (Democrat 9-0)

Status: (Introduced) 2025-01-14 - referred to insurance [A01963 Detail]

Download: New_York-2025-A01963-Introduced.html

---

                STATE OF NEW YORK
        ________________________________________________________________________

                                          1963

                               2025-2026 Regular Sessions

                   IN ASSEMBLY

                                    January 14, 2025
                                       ___________

        Introduced  by M. of A. SOLAGES, MITAYNES, EPSTEIN, TAYLOR, GONZALEZ-RO-
          JAS, JACOBSON, SIMON, DAVILA, JACKSON -- read once and referred to the
          Committee on Insurance

        AN ACT to amend the public health law, in relation to universal  newborn
          nurse  home visiting services; to amend the insurance law, in relation
          to requiring health insurance coverage  for  universal  newborn  nurse
          home  visiting services; authorizing the department of health to apply
          for certain waivers; and directing  the  superintendent  of  financial
          services  to require an insurer, health carrier or health benefit plan
          to notify enrollees annually of universal newborn nurse home  visiting
          services

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

     1    Section 1. The public health law is amended by adding  a  new  section
     2  2500-n to read as follows:
     3    §  2500-n.  Universal newborn nurse home visiting services. 1. As used
     4  in this section, "community" means a geographic region, county, tribe or
     5  other group of individuals living in proximity as defined by the depart-
     6  ment by rule.
     7    2. (a) The commissioner shall design, implement and maintain a  volun-
     8  tary  statewide program to provide universal newborn nurse home visiting
     9  services to all families with newborns residing in this state to support
    10  healthy child development  and  strengthen  families.  The  commissioner
    11  shall  design  the  universal  newborn nurse home visiting program to be
    12  flexible so as to meet the needs of the communities  where  the  program
    13  operates.
    14    (b) In designing the program described in paragraph (a) of this subdi-
    15  vision,  the  commissioner shall consult, coordinate and collaborate, as
    16  necessary, with insurers that offer health benefit plans in this  state,
    17  hospitals,  local  public  health  authorities,  the  early intervention

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04521-01-5
        A. 1963                             2

     1  program, existing early childhood  home  visiting  programs,  community-
     2  based organizations and social service providers.
     3    3. The program shall provide nurse home visiting services that are:
     4    (a)  based  on criteria established by the United States Department of
     5  Health and Human Services for an  evidence-based  early  childhood  home
     6  visiting service delivery model;
     7    (b)  provided  by registered nurses licensed in this state to families
     8  caring for newborns up to the age of six months,  including  foster  and
     9  adoptive newborns;
    10    (c) provided in the family's home; and
    11    (d)  aimed  at  improving  outcomes  in  one  or more of the following
    12  domains:
    13    (i) child health;
    14    (ii) child development and school readiness;
    15    (iii) family economic self-sufficiency;
    16    (iv) birth parent health;
    17    (v) positive parenting;
    18    (vi) reducing child mistreatment;
    19    (vii) reducing juvenile delinquency;
    20    (viii) reducing family violence; or
    21    (ix) reducing crime.
    22    4. The services provided in the program must:
    23    (a) be voluntary and carry no negative consequences for a family  that
    24  declines to participate;
    25    (b) be offered in every community in this state;
    26    (c)  include  an evidence-based assessment of the physical, social and
    27  emotional factors affecting the family;
    28    (d) be offered to all families with newborns residing in the community
    29  where the program operates;
    30    (e) include at least one visit during a newborn's first  three  months
    31  of  life with the opportunity for the family to choose up to three addi-
    32  tional visits;
    33    (f) include a follow-up visit no later than  three  months  after  the
    34  last visit; and
    35    (g) provide information and referrals to address each family's identi-
    36  fied needs.
    37    5.  The  authority  shall  collect  and  analyze data generated by the
    38  program to assess the effectiveness of the program in meeting  the  aims
    39  described  in  paragraph  (d)  of  subdivision three of this section and
    40  shall work with other state agencies to develop  protocols  for  sharing
    41  data,  including  the timely sharing of data with primary care providers
    42  of care to the families with newborns receiving the services.
    43    6.   The  commissioner  shall  adopt  by  rule,  consistent  with  the
    44  provisions  of  this  section, criteria for universal newborn nurse home
    45  visiting services that must be covered by health benefit plans.
    46    § 2. Subsection (i) of section 3216 of the insurance law is amended by
    47  adding a new paragraph 40 to read as follows:
    48    (40)(A) Every policy which  provides  hospital,  surgical  or  medical
    49  coverage  shall provide coverage for universal newborn nurse home visit-
    50  ing services as prescribed by the department of  health  by  rule  under
    51  section  twenty-five  hundred-l  of the public health law.  The coverage
    52  must be provided without any  cost-sharing,  coinsurance  or  deductible
    53  applicable to the services.
    54    (B) Insurers must offer universal newborn nurse home visiting services
    55  in  their health benefit plans but an individual enrolled in the plan is
        A. 1963                             3

     1  not required to receive the services as a condition of coverage and  may
     2  not be penalized or in any way discouraged from declining the services.
     3    (C)  An  insurer  must notify an individual enrolled in the plan about
     4  the universal newborn nurse home visiting services whenever  such  indi-
     5  vidual adds a newborn to coverage under the plan.
     6    (D) An insurer may use in-network providers or may contract with local
     7  public health authorities to provide the services.
     8    (E)  This  paragraph does not require an insurer to reimburse the cost
     9  of the services in any specific manner. The services may  be  reimbursed
    10  using:
    11    (i) a value-based payment methodology;
    12    (ii) a claim invoicing process;
    13    (iii) capitated payments;
    14    (iv)  a  payment  methodology  that  takes into account the need for a
    15  community-based entity providing the services to expand its capacity  to
    16  provide the services and address health disparities; or
    17    (v) any other methodology agreed to by the insurer and the provider of
    18  the services.
    19    (F)  Insurers  shall report to the department of public health, in the
    20  form and manner prescribed by the  department  of  public  health,  data
    21  regarding  claims submitted for services covered under this paragraph to
    22  monitor the provision of  the  universal  newborn  nurse  home  visiting
    23  services.
    24    § 3. Subsection (k) of section 3221 of the insurance law is amended by
    25  adding a new paragraph 24 to read as follows:
    26    (24)(A)  Every group  or blanket policy delivered or issued for deliv-
    27  ery in this state which   provides   hospital,   surgical   or   medical
    28  coverage  shall include coverage for universal newborn nurse home visit-
    29  ing services as prescribed by the department of  health  by  rule  under
    30  section  twenty-five  hundred-l  of the public health law.  The coverage
    31  must be provided without any  cost-sharing,  coinsurance  or  deductible
    32  applicable to the services.
    33    (B) Insurers must offer universal newborn nurse home visiting services
    34  in  their health benefit plans but an individual enrolled in the plan is
    35  not required to receive the services as a condition of coverage and  may
    36  not be penalized or in any way discouraged from declining the services.
    37    (C)  An  insurer  must notify an individual enrolled in the plan about
    38  the universal newborn nurse home visiting services whenever  such  indi-
    39  vidual adds a newborn to coverage under the plan.
    40    (D) An insurer may use in-network providers or may contract with local
    41  public health authorities to provide the services.
    42    (E)  This  paragraph does not require an insurer to reimburse the cost
    43  of the services in any specific manner. The services may  be  reimbursed
    44  using:
    45    (i) a value-based payment methodology;
    46    (ii) a claim invoicing process;
    47    (iii) capitated payments;
    48    (iv)  a  payment  methodology  that  takes into account the need for a
    49  community-based entity providing the services to expand its capacity  to
    50  provide the services and address health disparities; or
    51    (v) any other methodology agreed to by the insurer and the provider of
    52  the services.
    53    (F)  Insurers  shall report to the department of public health, in the
    54  form and manner prescribed by the  department  of  public  health,  data
    55  regarding  claims submitted for services covered under this paragraph to
        A. 1963                             4

     1  monitor the provision of  the  universal  newborn  nurse  home  visiting
     2  services.
     3    §  4.  Section  4303  of  the insurance law is amended by adding a new
     4  subsection (ww) to read as follows:
     5    (ww)(1) A medical  expense  indemnity  corporation, a hospital service
     6  corporation or a health service corporation that provides  coverage  for
     7  hospital, surgical or medical care shall include coverage for  universal
     8  newborn  nurse home visiting services as prescribed by the department of
     9  health by rule under section twenty-five hundred-l of the public  health
    10  law. The coverage must be provided without any cost-sharing, coinsurance
    11  or deductible applicable to the services.
    12    (2) Insurers must offer universal newborn nurse home visiting services
    13  in  their health benefit plans but an individual enrolled in the plan is
    14  not required to receive the services as a condition of coverage and  may
    15  not be penalized or in any way discouraged from declining the services.
    16    (3)  An  insurer  must notify an individual enrolled in the plan about
    17  the universal newborn nurse home visiting services whenever  such  indi-
    18  vidual adds a newborn to coverage under the plan.
    19    (4) An insurer may use in-network providers or may contract with local
    20  public health authorities to provide the services.
    21    (5)  This  paragraph does not require an insurer to reimburse the cost
    22  of the services in any specific manner. The services may  be  reimbursed
    23  using:
    24    (A) a value-based payment methodology;
    25    (B) a claim invoicing process;
    26    (C) capitated payments;
    27    (D)  a  payment  methodology  that  takes  into account the need for a
    28  community-based entity providing the services to expand its capacity  to
    29  provide the services and address health disparities; or
    30    (E) any other methodology agreed to by the insurer and the provider of
    31  the services.
    32    (6)  Insurers  shall report to the department of public health, in the
    33  form and manner prescribed by the  department  of  public  health,  data
    34  regarding  claims submitted for services covered under this paragraph to
    35  monitor the provision of  the  universal  newborn  nurse  home  visiting
    36  services.
    37    §  5.  The  department  of health may request a waiver for state inno-
    38  vation under 42 U.S.C. 18052 to obtain federal  financial  participation
    39  in  the  cost of services provided under sections two, three and four of
    40  this act.
    41    § 6. The superintendent of financial services shall require an  insur-
    42  er,  health  carrier or health benefit plan to notify enrollees annually
    43  of universal newborn nurse home visiting services covered by such enrol-
    44  lees' health benefit plan. The notice shall be delivered by mail  unless
    45  the enrollee and health carrier have agreed on another method of notifi-
    46  cation.  The  superintendent  of  financial  services  is  authorized to
    47  promulgate necessary rules and regulations for the purposes of providing
    48  such notification.
    49    § 7. This act shall take effect on the ninetieth day  after  it  shall
    50  have  become  a  law  and  shall  apply to any policy issued, delivered,
    51  renewed, and/or modified on or after the effective  date  of  this  act.
    52  Effective immediately, the addition, amendment and/or repeal of any rule
    53  or regulation necessary for the implementation of this act on its effec-
    54  tive  date  are  authorized  to  be made and completed on or before such
    55  effective date.