What's happening
This bill requires insurance companies to accept early intervention service plans for infants and toddlers as pre-authorization and prohibits treating qualified providers as out-of-network.
Why it matters
Streamlines access to critical early intervention services for infants and toddlers with disabilities. by making it easier for families to use their insurance—insurers must treat the state-mandated service plan as sufficient for pre-authorization, reducing bureaucratic hurdles and delays in care.
Reduces unexpected costs for families. by requiring private insurers to treat qualified early intervention providers as in-network, protecting families from higher out-of-network charges and making services more affordable.
Ensures consistent coverage regardless of insurance plan. by applying these requirements to all insurers, including HMOs and other health plans, closing loopholes that previously allowed some plans to deny or restrict coverage for early intervention therapies.
Supports timely and coordinated care. for children with disabilities by aligning insurance requirements with the state's early intervention system, leading to better developmental outcomes and less administrative burden for both families and providers.
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Who cares
Headline styles
Cover Early Intervention Services
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
- Referred to insurance
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
4684
2017-2018 Regular Sessions
IN ASSEMBLY
February 3, 2017
Introduced by M. of A. O'DONNELL -- read once and referred to the Committee on Insurance
AN ACT to amend the public health law and the insurance law, in relation to insurance reimbursement for early intervention services for infants and toddlers with disabilities
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subdivision 3 of section 2559 of the public health law is amended by adding a new paragraph (e) to read as follows:
(e) An insurer or health plan administrator shall accept the early intervention individual family service plan as documentation of pre-authorization and prior approval for such services to an eligible child. All such services shall be considered "covered services". A qualified provider of early intervention services, as defined in this article, shall not be considered an out-of-network provider for purposes of coverage under an insurance policy or health insurance plan.
§ 2. Section 3235-a of the insurance law is amended by adding a new subsection (e) to read as follows:
(e) No insurer, including a health maintenance organization issued a certificate of authority under article forty-four of the public health law and a corporation organized under article forty-three of this chapter, shall refuse to accept the early intervention individual family service plan as documentation of pre-authorization and prior approval for such services to an eligible child. All such services shall be considered "covered services". A qualified provider of early intervention services, as defined in this article, shall not be considered an out-of-network provider for purposes of coverage under an insurance policy or health insurance plan.
§ 3. This act shall take effect immediately.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD09431-01-7
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.