Bill Text: NY A07790 | 2023-2024 | General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Expands insurance coverage requirements for human donor milk; removes the requirement for inpatient use.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Passed) 2024-10-01 - signed chap.422 [A07790 Detail]

Download: New_York-2023-A07790-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          7790

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                      June 15, 2023
                                       ___________

        Introduced  by M. of A. SOLAGES -- read once and referred to the Commit-
          tee on Insurance

        AN ACT to amend the social  services  law  and  the  insurance  law,  in
          relation to expanding coverage requirements for human donor milk

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

     1    Section 1. Paragraph (dd) of subdivision 2 of  section  365-a  of  the
     2  social  services  law,  as added by section 3 of part S of chapter 57 of
     3  the laws of 2017, is amended to read as follows:
     4    (dd) pasteurized donor human milk (PDHM), which may include fortifiers
     5  as medically indicated[,  for  inpatient  use],  for  which  a  licensed
     6  medical  practitioner has issued an order for an infant who is medically
     7  or physically unable to receive maternal breast milk or  participate  in
     8  breast  feeding  or  whose  mother  is medically or physically unable to
     9  produce maternal breast milk at  all  or  in  sufficient  quantities  or
    10  participate  in  breast  feeding despite optimal lactation support. Such
    11  infant shall: (i) have a documented birth weight of less than one  thou-
    12  sand five hundred grams; or (ii) have a congenital or acquired condition
    13  that  places  the  infant  at a high risk for development of necrotizing
    14  enterocolitis; or (iii) have a congenital or acquired condition that may
    15  benefit from the use of donor breast milk as determined by  the  commis-
    16  sioner of health or his or her designee.
    17    §  2.  Paragraph 38 of subsection (i) of section 3216 of the insurance
    18  law, as added by section 10 of part MM of chapter 57 of the laws of 2018
    19  and as renumbered by chapter 739 of the laws of 2022, is amended to read
    20  as follows:
    21    (38) Every policy that provides coverage  for  hospital,  surgical  or
    22  medical  care shall provide the following coverage for pasteurized donor
    23  human milk (PDHM), which may include fortifiers as medically indicated[,
    24  for inpatient use], for which a licensed medical practitioner has issued
    25  an order for an infant who is medically or physically unable to  receive

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11129-02-3
        A. 7790                             2

     1  maternal breast milk or participate in breast feeding or whose mother is
     2  medically or physically unable to produce maternal breast milk at all or
     3  in  sufficient quantities or participate in breast feeding despite opti-
     4  mal  lactation  support.  Such infant shall: (i) have a documented birth
     5  weight of less than one thousand five hundred  grams;  or  (ii)  have  a
     6  congenital  or  acquired condition that places the infant at a high risk
     7  for development of necrotizing enterocolitis.
     8    § 3. Paragraph 20 of subsection (l) of section 3221 of  the  insurance
     9  law,  as  added  by  section  11 of part MM of chapter 57 of the laws of
    10  2018, is amended to read as follows:
    11    (20) Every insurer delivering a group or blanket policy or  issuing  a
    12  group  or blanket policy for delivery in this state that provides cover-
    13  age for hospital, surgical or medical care shall provide  the  following
    14  coverage  for  pasteurized  donor  human  milk (PDHM), which may include
    15  fortifiers as medically indicated[, for  inpatient  use],  for  which  a
    16  licensed  medical  practitioner has issued an order for an infant who is
    17  medically or physically  unable  to  receive  maternal  breast  milk  or
    18  participate in breast feeding or whose mother is medically or physically
    19  unable  to  produce maternal breast milk at all or in sufficient quanti-
    20  ties or participate in breast feeding despite optimal lactation support.
    21  Such infant shall: (i) have a documented birth weight of less  than  one
    22  thousand  five  hundred  grams;  or  (ii)  have a congenital or acquired
    23  condition that places the infant at  a  high  risk  for  development  of
    24  necrotizing enterocolitis.
    25    § 4. Subsection (oo) of section 4303 of the insurance law, as added by
    26  section  12  of part MM of chapter 57 of the laws of 2018, is amended to
    27  read as follows:
    28    (oo) A medical  expense  indemnity  corporation,  a  hospital  service
    29  corporation  or  a health service corporation that provides coverage for
    30  hospital, surgical or medical care shall provide the following  coverage
    31  for pasteurized donor human milk (PDHM), which may include fortifiers as
    32  medically  indicated[,  for inpatient use], for which a licensed medical
    33  practitioner has issued an order for an infant who is medically or phys-
    34  ically unable to receive maternal breast milk or participate  in  breast
    35  feeding  or  whose  mother  is medically or physically unable to produce
    36  maternal breast milk at all or in sufficient quantities  or  participate
    37  in  breast feeding despite optimal lactation support. Such infant shall:
    38  (i) have a documented birth  weight  of  less  than  one  thousand  five
    39  hundred  grams;  or  (ii)  have  a congenital or acquired condition that
    40  places the infant at a high risk for development of necrotizing  entero-
    41  colitis.
    42    §  5. This act shall take effect on the first of January next succeed-
    43  ing the date on which it shall have become a law and shall apply to  all
    44  policies  issued,  renewed,  modified, or altered on or after such date.
    45  Effectively immediately, the addition, amendment and/or  repeal  of  any
    46  rule  or  regulation necessary for the implementation of this act on its
    47  effective date are authorized to be made and completed on or before such
    48  date.