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History
- Referred to insurance
- Referred to insurance
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Sponsor's memo
BILL NUMBER:S1611
Title of bill
An act to amend the insurance law, in relation to coverage for the care of Alzheimer's and related disease patients
Purpose of the bill
To require all health insurance providers of New York State to make available, when requested by a contract holder, coverage for a designated group of non-health related services provided to Alzheimer's or related diseases. These services are custodial in nature, and include crisis intervention, adult day care, home care, and respite care.
Summary of specific provisions
This bill adds insurance coverage for non-health related services required by Alzheimer's and related disease victims. Under current Insurance Law there is no provision for that group of services.
Subsection (i) of §3216 of the Insurance Law is amended by adding a new paragraph eleven. Subsection (1) of §3221 of such law is amended by adding a new paragraph eighteen.
Justification
Alzheimer's disease is a progressively degenerative neurological disorder with no known cause or cure. The course of this disease as well as other dementias usually extends over a number of years, necessitating the use of many non-health related services, such as adult day care, home care, and respite care. Because this type of care is considered custodial, victims of Alzheimer's and related dementias do not have access to the traditional funding mechanisms for health care.
Medicare and Medicaid are currently the major sources of financing for both institutional and community based care. Because Medicare does not cover services needed for long-term chronic care, and Medicaid requires that an individual be financially destitute in order to be eligible for coverage, Alzheimer's victims are denied reimbursement for their much needed care. The private/commercial insurers of New York State currently require that care be of a rehabilitative nature further eliminating access to reimbursement for this group of patients. It is time for New York State to require insurers to provide this coverage.
Legislative history
2009-10: S.4229
Fiscal implications for state and local governments
To be determined.
Effective date
One hundred twenty days after it shall have become a law, with provisions.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.