What's happening
This bill requires health insurance policies in New York to cover prosthetic devices for veterans injured in the line of duty.
Why it matters
Improves financial protection for injured veterans. By mandating insurance coverage for prosthetic devices (including repairs and replacements), the bill helps veterans avoid high out-of-pocket costs that can otherwise be a substantial burden after a service-related injury.
Defines the scope of covered prosthetic care. The bill clarifies that coverage includes not only artificial limbs but also all related services and components, ensuring comprehensive support for veterans’ rehabilitation needs, while excluding ordinary apparel.
Aligns with federal standards and insurance practices. By tying coverage requirements to federal definitions (42 U.S.C. § 18022) and matching deductibles/coinsurance with other essential health benefits, the law integrates prosthetic coverage into mainstream health insurance policy structures, likely making implementation smoother for insurers and consumers.
Targets support to New York resident veterans with service-connected injuries. The bill specifically benefits veterans who reside in New York and whose prosthetic needs arise from injuries sustained in the line of duty, focusing resources on a group with demonstrated need and service to the state and nation.
Albany, before your first meeting.
Every bill that moved yesterday, summarized in a sentence and ranked by impact. The Albany Scorecard follows on Sundays.
Free. Unsubscribe in one click. Want alerts on specific bills? Create an account.
Who cares
Headline styles
Require Insurance for Prosthetics
Plain English, a few words. Used as the page title.
Sponsors
3 Co-sponsors
History
- Referred to insurance
- Referred to insurance
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
6304
2017-2018 Regular Sessions
IN ASSEMBLY
March 2, 2017
Introduced by M. of A. CRESPO, RAIA, RIVERA, PALMESANO -- Multi-Sponsored by -- M. of A. ARROYO, DAVILA, HOOPER, JOYNER, LAVINE, PICHARDO, RODRIGUEZ, SEPULVEDA -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to mandatory health insurance coverage for prosthetic devices
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 34 to read as follows:
(34) Every policy which provides medical, major medical, or similar comprehensive type coverage shall provide coverage for prosthetic devices, including repairs and replacements, that are intended for medically necessary rehabilitative and habilitative purposes as required by 42 U.S.C. § 18022. As such, prosthetic device coverage shall be subject to annual deductibles and coinsurance as deemed appropriate by the superintendent in amounts no greater than other essential health benefits covered by the policy. The term "prosthetic device" as used in this paragraph includes an artificial limb and all the components and related services that comprise prosthetic care but shall not include shoes or any other article considered as ordinary wearing apparel, whether or not specially constructed. The term "policy holder" as used in this paragraph shall mean a veteran of the armed forces who resides in the state of New York and whose medical need for such prosthetic device resulted from an injury suffered in the line of duty while serving in the armed forces.
§ 2. Subsection (l) of section 3221 of the insurance law is amended by adding a new paragraph 20 to read as follows:
(20) Every policy which provides medical, major medical, or similar comprehensive type coverage shall provide coverage for prosthetic devices, including repairs and replacements, that are intended for
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD07398-02-7
A. 6304 2
medically necessary rehabilitative and habilitative purposes as required by 42 U.S.C. § 18022. As such, prosthetic device coverage shall be subject to annual deductibles and coinsurance as deemed appropriate by the superintendent in amounts no greater than other essential health benefits covered by the policy. The term "prosthetic device" as used in this paragraph includes an artificial limb and all the components and related services that comprise prosthetic care but shall not include shoes or any other article considered as ordinary wearing apparel, whether or not specially constructed. The term "policy holder" as used in this paragraph shall mean a veteran of the armed forces who resides in the state of New York and whose medical need for such prosthetic device resulted from an injury suffered in the line of duty while serving in the armed forces.
§ 3. Section 4303 of the insurance law is amended by adding a new subsection (rr) to read as follows:
(rr) Every policy which provides medical, major medical, or similar comprehensive type coverage shall provide coverage for prosthetic devices, including repairs and replacements, that are intended for medically necessary rehabilitative and habilitative purposes as required by 42 U.S.C. § 18022. As such, prosthetic device coverage shall be subject to annual deductibles and coinsurance as deemed appropriate by the superintendent in amounts no greater than other essential health benefits covered by the policy. The term "prosthetic device" as used in this subsection includes an artificial limb and all of the components and related services that comprise prosthetic care but shall not include shoes or any other article considered as ordinary wearing apparel, whether or not specially constructed. The term "policy holder" as used in this subsection shall mean a veteran of the armed forces who resides in the state of New York and whose medical need for such prosthetic device resulted from an injury suffered in the line of duty while serving in the armed forces.
§ 4. This act shall take effect on the ninetieth day after it shall have become a law and shall apply to policies and contracts issued, renewed, altered, or amended on or after such effective date.
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.