Bill Text: NY S05481 | 2023-2024 | General Assembly | Amended

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Bill Title: Requires insurance policies to cover neuropsychological exams for dyslexia under certain circumstances; caps coverage amount.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced) 2024-06-07 - SUBSTITUTED BY A2898A [S05481 Detail]

Download: New_York-2023-S05481-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         5481--A

                               2023-2024 Regular Sessions

                    IN SENATE

                                      March 6, 2023
                                       ___________

        Introduced  by Sen. HOYLMAN-SIGAL -- read twice and ordered printed, and
          when printed to be committed to the Committee on Insurance --  commit-
          tee  discharged, bill amended, ordered reprinted as amended and recom-
          mitted to said committee

        AN ACT to amend the insurance law,  in  relation  to  requiring  certain
          insurance policies to cover neuropsychological exams for dyslexia

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

     1    Section 1. This act shall be known and may be cited as  the  "dyslexia
     2  diagnosis access act".
     3    § 2. Legislative findings and intent. The legislature hereby finds and
     4  declares the following:
     5    a.  Dyslexia is a specific learning disability that is neurobiological
     6  in origin. It is characterized  by  difficulties  with  accurate  and/or
     7  fluent  word  recognition  and impaired spelling and decoding abilities.
     8  These difficulties typically result from a deficit in  the  phonological
     9  component of language within the brain that is often discordant with the
    10  person's  intelligence and other cognitive abilities. Secondary  effects
    11  of undetected and unaddressed dyslexia  include    anxiety,  depression,
    12  worsened  health,  decreased  life  expectancy, lower   education rates,
    13  lower employment and income rates, and increased  poverty and incarcera-
    14  tion rates.
    15    b. Studies indicate that as many as one  in  five  children  may  have
    16  dyslexia or another phonemic awareness issue. However, lack of access to
    17  appropriate  screening and diagnostic testing poses a barrier to compre-
    18  hensively tracking the incidence of dyslexia and students  are  unlikely
    19  to  receive  the  intervention  required  to overcome dyslexia without a
    20  positive diagnosis. Comprehensive neuropsychological  exams  are  recog-
    21  nized  as  the most effective way to positively diagnose dyslexia.  Such
    22  exams are often administered over the course of two days  and  currently

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01994-03-3
        S. 5481--A                          2

     1  may  cost  in  excess of six thousand dollars but are typically not paid
     2  for by health insurance, making them unaffordable to many families.
     3    § 3. Subsection (i) of section 3216 of the insurance law is amended by
     4  adding a new paragraph 39 to read as follows:
     5    (39)  (A)  Every policy that provides coverage for physician services,
     6  medical, major medical  or  similar  comprehensive-type  coverage  shall
     7  provide  coverage  for testing for suspected dyslexia in accordance with
     8  this paragraph and shall not exclude coverage for the screening, diagno-
     9  sis or treatment of medical conditions otherwise covered by the policy.
    10    (B) Coverage shall include comprehensive  neuropsychological  examina-
    11  tions  for  the  purposes  of  diagnosing  dyslexia  and determining the
    12  psychological, emotional, and educational wellness needs of the individ-
    13  ual tested.
    14    § 4. Section 3221 of the insurance law is  amended  by  adding  a  new
    15  subsection (u) to read as follows:
    16    (u)  (1)  Every  policy that provides coverage for physician services,
    17  medical, major medical  or  similar  comprehensive-type  coverage  shall
    18  provide  coverage  for testing for suspected dyslexia in accordance with
    19  this subsection and shall not exclude coverage for the screening,  diag-
    20  nosis  or treatment of medical conditions otherwise covered by the poli-
    21  cy.
    22    (2) Coverage shall include comprehensive  neuropsychological  examina-
    23  tions  for  the  purposes  of  diagnosing  dyslexia  and determining the
    24  psychological, emotional, and educational wellness needs of the individ-
    25  ual tested.
    26    § 5. Section 4303 of the insurance law is  amended  by  adding  a  new
    27  subsection (vv) to read as follows:
    28    (vv)  (1)  Every policy that provides coverage for physician services,
    29  medical, major medical  or  similar  comprehensive-type  coverage  shall
    30  provide  coverage  for testing for suspected dyslexia in accordance with
    31  this subsection and shall not exclude coverage for the screening,  diag-
    32  nosis  or treatment of medical conditions otherwise covered by the poli-
    33  cy.
    34    (2) Coverage shall include comprehensive  neuropsychological  examina-
    35  tions  for  the  purposes  of  diagnosing  dyslexia  and determining the
    36  psychological, emotional, and educational wellness needs of the individ-
    37  ual tested.
    38    § 6. This act shall take effect on the first of January next  succeed-
    39  ing  the date on which it shall have become a law and shall apply to all
    40  policies and contracts issued, renewed, modified, altered, or amended on
    41  or after such  date.  Effective  immediately,  the  addition,  amendment
    42  and/or repeal of any rule or regulation necessary for the implementation
    43  of  this  act  on  its  effective  date  are  authorized  to be made and
    44  completed on or before such effective date.