Provides coverage for reproductive health services to enrollees of medicaid, family health plus and child health plus

1 Co-sponsor

• José Peralta

Title of bill

An act to amend the public health law and the social services law, in relation to providing coverage for reproductive health services to enrollees of medicaid, family health plus and child health plus

Purpose

This bill would provide coverage for reproductive health services to enrollees of Medicaid, Family Health Plus, and Child Health Plus.

Section 1 amends subdivision 7 of section 2510 of the Public Health Law, as amended by Chapter 645 of the Laws of 2005, to add reproductive health care services to the definition of "covered health care services" under Child Health Plus.

Section 2 amends paragraph (a) of subdivision 7 of section 2510 of the Public Health Law to add reproductive health care services to the definition of "primary and preventive health care services" under Child Health Plus.

Section 3 of the bill adds a new paragraph (z) to subdivision 1 of section 364-j of the Social Services Law to define "reproductive health care services."

Section 4 adds a new paragraph to subdivision 4 of section 364-j of the Social Services Law to require Medicaid managed care providers to provide or arrange for all reproductive health care services.

Section 5 amends subparagraphs (xv) and (xvi) of paragraph (e) of subdivision 1 of section 369-ee of the Social Services Law, and adds a new subparagraph (xvii) to add reproductive health services to the definition of "health care services" that are covered by Family Health Plus.

Section 6 adds a new Subparagraph (vii) to paragraph (d) of subdivision 3 of section 369-ee of the Social Services Law to retire family health insurance plans under Family Health Plus to provide or arrange for all reproductive health care services.

Section 7 is a severability clause.

Section 8 states the effective date.

Justification

Family planning services are an essential part of women's health care. American women, regardless of income, experience high rates of unintended pregnancy and sexually transmitted disease. Adequate family planning care can significantly help to address these problems.

Under New York's rules, Medicaid, Family Health Plus and Child Health plus managed care plans can choose to either provide or exclude coverage for family planning care. Plans are given two options: 1) Receive payments for family planning services and accept responsibility and pay for these services when care is delivered by an in-network provider, or 2) opt out of providing family planning care and not receive money for family planning services in their capitation rate.

When a managed care plan opts out of providing family planning care, the state's goal of providing patients with better coordinated, continuous care by offering a "medical home" is compromised. Women who normally would see their in-network ob/gyns or primary care physicians to avert unintended pregnancy, ensure healthy pregnancies, and prevent a rage of health problems including cervical cancer and sexually transmitted disease, must now obtain these services from other providers. Unfortunately, obtaining these services elsewhere, or even realizing that they must be obtained elsewhere, may not be easy for the patient.

This measure will protect low-income women's access to the full range of health services available to all New Yorkers by requiring all health plans operating in New York State to provide family planning care.

Legislative history

2007-08 S.3963 Referred to the Committee on Health

Fiscal implications

None noted.

Effective date

On the ninetieth day after it becomes law.