What's happening
This bill requires health insurance policies offered on New York's exchange to cover acupuncture services by licensed providers.
Why it matters
Ensures equal treatment for acupuncture. The bill prohibits insurance plans from imposing higher deductibles, co-pays, or limits on acupuncture than on other essential health benefits, helping prevent discrimination against this form of care.
Expands access to alternative medicine. By mandating coverage for acupuncture provided by licensed practitioners, the bill increases patient access to non-pharmaceutical, non-surgical treatment options for various conditions.
Protects patient choice and provider rights. The language explicitly bars insurers from restricting or impeding the lawful practice of acupuncture, including services provided in hospital settings, which helps safeguard both patient and provider autonomy.
Potentially impacts insurance costs and utilization. Allowing reasonable utilization review and cost-sharing may help insurers manage costs, but the mandated coverage could lead to increased utilization of acupuncture services, affecting overall healthcare spending and plan premiums.
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Who cares
Health insurance exchange enrollees
The bill would require their policies to cover acupuncture, with cost-sharing, benefit limits and utilization review no greater than those for other essential health benefits.
Insurers offering exchange policies
They would have to cover acupuncture provided by practitioners licensed, authorized or certified under state law and could not use coverage restrictions to discriminate against acupuncture treatment.
Licensed acupuncturists
The bill would require exchange coverage for their services and preserve the provision and coverage of acupuncture within their lawful scope of practice as hospital staff or employees.
Headline styles
Require Insurance for Acupuncture
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Require Insurance for Acupuncture
In Assembly Committee · Insurance · Sponsor Ron Kim
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
4560
2019-2020 Regular Sessions
IN SENATE
March 14, 2019
Introduced by Sen. PARKER -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to mandatory health insurance coverage for acupuncture services
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 35 to read as follows:
(35) Every policy issued within the health benefit exchange established pursuant to section 1311 of the affordable care act, 42 U.S.C. § 18031, shall provide coverage for acupuncture treatment as defined in section eight thousand two hundred eleven of the education law provided by an individual licensed, authorized, or certified pursuant to article one hundred sixty of the education law. However, acupuncture treatment and services may be subject to reasonable deductible, co-payment and co-insurance amount, reasonable fee or benefit limits, and reasonable utilization review, provided that any such amounts, limits or review shall be no greater than other essential health benefits covered by the policy and provided further that any such amounts, limits, or review shall not function to direct treatment in a manner discriminative against acupuncture treatment. Nothing herein shall be construed as impending or preventing either the provision or coverage of acupuncture treatment and services by duly licensed or certified acupuncturist, within the lawful scope of the practice of acupuncture, in hospital facilities on a staff or employee basis.
§ 2. Section 4303 of the insurance law is amended by adding a new subsection (ss) to read as follows:
(ss) Every policy issued within the health benefit exchange established pursuant to section 1311 of the affordable care act, 42 U.S.C. § 18031, shall provide coverage for acupuncture treatment as defined in section eight thousand two hundred eleven of the education law provided
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD03865-01-9
S. 4560 2
by an individual licensed, authorized, or certified pursuant to article one hundred sixty of the education law. However, acupuncture treatment and services may be subject to reasonable deductible, co-payment and co-insurance amount, reasonable fee or benefit limits, and reasonable utilization review, provided that any such amounts, limits or review shall be no greater than other essential health benefits covered by the policy and provided further that any such amounts, limits, or review shall not function to direct treatment in a manner discriminative against acupuncture treatment. Nothing herein shall be construed as impeding or preventing either the provision or coverage of acupuncture treatment and services by duly licensed or certified acupuncturists, within the lawful scope of the practice of acupuncture, in hospital facilities on a staff or employees basis.
§ 3. 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, modified, altered or amended on or after such effective date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the insurance law, in relation to mandatory health insurance coverage for acupuncture services
Summary of specific provisions
Section 1 would amend subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 34.
Section 2 would amend section 4303 of the insurance law is amended by adding a new subsection (rr).
Section 3 provides that the effective date for this legislation shall be 90 days after it is signed into law.
Justification
The ACA ensured access of all New Yorkers to a basic level of health- care, which included "essential health benefits" which are loosely outlined by the Federal Government. States are permitted to expand these "essential health benefits" in order to provide their citizens with greater access to basic levels of care. Acupuncture is currently not provided for as an essential health benefit in New York, and is not covered by New York's basic health plan. This leaves many New Yorker's without the ability to afford this important treatment.
Acupuncture has been shown to be effective in treating a number of conditions, including chronic pain, nausea, headaches, anxiety, depression, insomnia and infertility. Acupuncture is also a cost effec- tive alternative to some other forms of treatment, often resulting in permanent improvement for patients with chronic conditions. Acupuncture has been shown to be effective in treating chronic pain as an alterna- tive to opioids. This makes adding acupuncture as an essential health benefit even more important given the opioid epidemic facing the state. Ensuring that citizens have access to quality acupuncture as part of their basic health insurance offered on the health exchange should be a key part of New York's public health plan.
Prior legislative history
2017-18: S7636 - Referred to Insurance 2015-2016: A.10322 (Kim), Referred to insurance
Fiscal implications
The State may be liable for any difference in premiums paid in the event that adding acupuncture as an essential health benefit creates an addi- tional cost to plans. Given its relative cost effecti,enessòcompared to other means of treatment, it could result in no cost/p'egmium increases, or a reduction.
Effective date
This act shall take effect 90 days after it becomes law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.