Bill Text: NY A06526 | 2023-2024 | 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 3-0)
Status: (Introduced) 2024-01-03 - referred to insurance [A06526 Detail]
Download: New_York-2023-A06526-Introduced.html
STATE OF NEW YORK ________________________________________________________________________ 6526 2023-2024 Regular Sessions IN ASSEMBLY April 13, 2023 ___________ Introduced by M. of A. SOLAGES -- read once and referred to the Commit- tee 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-l to read as follows: 3 § 2500-l. 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 18 program, existing early childhood home visiting programs, community- 19 based organizations and social service providers. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [] is old law to be omitted. LBD08155-01-3A. 6526 2 1 3. The program shall provide nurse home visiting services that are: 2 (a) based on criteria established by the United States Department of 3 Health and Human Services for an evidence-based early childhood home 4 visiting service delivery model; 5 (b) provided by registered nurses licensed in this state to families 6 caring for newborns up to the age of six months, including foster and 7 adoptive newborns; 8 (c) provided in the family's home; and 9 (d) aimed at improving outcomes in one or more of the following 10 domains: 11 (i) child health; 12 (ii) child development and school readiness; 13 (iii) family economic self-sufficiency; 14 (iv) maternal health; 15 (v) positive parenting; 16 (vi) reducing child mistreatment; 17 (vii) reducing juvenile delinquency; 18 (viii) reducing family violence; or 19 (ix) reducing crime. 20 4. The services provided in the program must: 21 (a) be voluntary and carry no negative consequences for a family that 22 declines to participate; 23 (b) be offered in every community in this state; 24 (c) include an evidence-based assessment of the physical, social and 25 emotional factors affecting the family; 26 (d) be offered to all families with newborns residing in the community 27 where the program operates; 28 (e) include at least one visit during a newborn's first three months 29 of life with the opportunity for the family to choose up to three addi- 30 tional visits; 31 (f) include a follow-up visit no later than three months after the 32 last visit; and 33 (g) provide information and referrals to address each family's identi- 34 fied needs. 35 5. The authority shall collect and analyze data generated by the 36 program to assess the effectiveness of the program in meeting the aims 37 described in paragraph (d) of subdivision three of this section and 38 shall work with other state agencies to develop protocols for sharing 39 data, including the timely sharing of data with primary care providers 40 of care to the families with newborns receiving the services. 41 6. The commissioner shall adopt by rule, consistent with the 42 provisions of this section, criteria for universal newborn nurse home 43 visiting services that must be covered by health benefit plans. 44 § 2. Subsection (i) of section 3216 of the insurance law is amended by 45 adding a new paragraph 39 to read as follows: 46 (39)(A) Every policy which provides hospital, surgical or medical 47 coverage shall provide coverage for universal newborn nurse home visit- 48 ing services as prescribed by the department of health by rule under 49 section twenty-five hundred-l of the public health law. The coverage 50 must be provided without any cost-sharing, coinsurance or deductible 51 applicable to the services. 52 (B) Insurers must offer universal newborn nurse home visiting services 53 in their health benefit plans but an individual enrolled in the plan is 54 not required to receive the services as a condition of coverage and may 55 not be penalized or in any way discouraged from declining the services.A. 6526 3 1 (C) An insurer must notify an individual enrolled in the plan about 2 the universal newborn nurse home visiting services whenever such indi- 3 vidual adds a newborn to coverage under the plan. 4 (D) An insurer may use in-network providers or may contract with local 5 public health authorities to provide the services. 6 (E) This paragraph does not require an insurer to reimburse the cost 7 of the services in any specific manner. The services may be reimbursed 8 using: 9 (i) a value-based payment methodology; 10 (ii) a claim invoicing process; 11 (iii) capitated payments; 12 (iv) a payment methodology that takes into account the need for a 13 community-based entity providing the services to expand its capacity to 14 provide the services and address health disparities; or 15 (v) any other methodology agreed to by the insurer and the provider of 16 the services. 17 (F) Insurers shall report to the department of public health, in the 18 form and manner prescribed by the department of public health, data 19 regarding claims submitted for services covered under this paragraph to 20 monitor the provision of the universal newborn nurse home visiting 21 services. 22 § 3. Subsection (k) of section 3221 of the insurance law is amended by 23 adding a new paragraph 23 to read as follows: 24 (23)(A) Every group or blanket policy delivered or issued for deliv- 25 ery in this state which provides hospital, surgical or medical 26 coverage shall include coverage for universal newborn nurse home visit- 27 ing services as prescribed by the department of health by rule under 28 section twenty-five hundred-l of the public health law. The coverage 29 must be provided without any cost-sharing, coinsurance or deductible 30 applicable to the services. 31 (B) Insurers must offer universal newborn nurse home visiting services 32 in their health benefit plans but an individual enrolled in the plan is 33 not required to receive the services as a condition of coverage and may 34 not be penalized or in any way discouraged from declining the services. 35 (C) An insurer must notify an individual enrolled in the plan about 36 the universal newborn nurse home visiting services whenever such indi- 37 vidual adds a newborn to coverage under the plan. 38 (D) An insurer may use in-network providers or may contract with local 39 public health authorities to provide the services. 40 (E) This paragraph does not require an insurer to reimburse the cost 41 of the services in any specific manner. The services may be reimbursed 42 using: 43 (i) a value-based payment methodology; 44 (ii) a claim invoicing process; 45 (iii) capitated payments; 46 (iv) a payment methodology that takes into account the need for a 47 community-based entity providing the services to expand its capacity to 48 provide the services and address health disparities; or 49 (v) any other methodology agreed to by the insurer and the provider of 50 the services. 51 (F) Insurers shall report to the department of public health, in the 52 form and manner prescribed by the department of public health, data 53 regarding claims submitted for services covered under this paragraph to 54 monitor the provision of the universal newborn nurse home visiting 55 services.A. 6526 4 1 § 4. Section 4303 of the insurance law is amended by adding a new 2 subsection (uu) to read as follows: 3 (uu)(1) A medical expense indemnity corporation, a hospital service 4 corporation or a health service corporation that provides coverage for 5 hospital, surgical or medical care shall include coverage for universal 6 newborn nurse home visiting services as prescribed by the department of 7 health by rule under section twenty-five hundred-l of the public health 8 law. The coverage must be provided without any cost-sharing, coinsurance 9 or deductible applicable to the services. 10 (2) Insurers must offer universal newborn nurse home visiting services 11 in their health benefit plans but an individual enrolled in the plan is 12 not required to receive the services as a condition of coverage and may 13 not be penalized or in any way discouraged from declining the services. 14 (3) An insurer must notify an individual enrolled in the plan about 15 the universal newborn nurse home visiting services whenever such indi- 16 vidual adds a newborn to coverage under the plan. 17 (4) An insurer may use in-network providers or may contract with local 18 public health authorities to provide the services. 19 (5) This paragraph does not require an insurer to reimburse the cost 20 of the services in any specific manner. The services may be reimbursed 21 using: 22 (A) a value-based payment methodology; 23 (B) a claim invoicing process; 24 (C) capitated payments; 25 (D) a payment methodology that takes into account the need for a 26 community-based entity providing the services to expand its capacity to 27 provide the services and address health disparities; or 28 (E) any other methodology agreed to by the insurer and the provider of 29 the services. 30 (6) Insurers shall report to the department of public health, in the 31 form and manner prescribed by the department of public health, data 32 regarding claims submitted for services covered under this paragraph to 33 monitor the provision of the universal newborn nurse home visiting 34 services. 35 § 5. The department of health may request a waiver for state inno- 36 vation under 42 U.S.C. 18052 to obtain federal financial participation 37 in the cost of services provided under sections two, three and four of 38 this act. 39 § 6. The superintendent of financial services shall require an insur- 40 er, health carrier or health benefit plan to notify enrollees annually 41 of universal newborn nurse home visiting services covered by such enrol- 42 lees' health benefit plan. The notice shall be delivered by mail unless 43 the enrollee and health carrier have agreed on another method of notifi- 44 cation. The superintendent of financial services is authorized to 45 promulgate necessary rules and regulations for the purposes of providing 46 such notification. 47 § 7. This act shall take effect on the ninetieth day after it shall 48 have become a law and shall apply to any policy issued, delivered, 49 renewed, and/or modified on or after the effective date of this act. 50 Effective immediately, the addition, amendment and/or repeal of any rule 51 or regulation necessary for the implementation of this act on its effec- 52 tive date are authorized to be made and completed on or before such 53 effective date.
