NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1096
SPONSOR: Bichotte Hermelyn TITLE OF BILL:
An act to amend the insurance law, in relation to requiring insurance
policies to provide coverage for pre-term labor hospitalizations, home
visits to monitor pre-term labor patients and counseling
PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this bill is to have healthcare services provided to
expectant mothers in pre-term labor covered by insurance carriers.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 amends item (i) of subparagraph-(A) of paragraph 10 of
subsection (i) of section 3216 of the insurance law as amended by chap-
ter 238 of the laws of 2010 to include two new subparagraphs (C)and (D).
Adding expectant mothers in pre-term labor. Subparagraph (C) includes
provision for part-time or intermittent home nursing care by or under
the supervision of registered professional nurse to monitor expectant
mothers diagnosed by physicians as having experienced pre-term labor;
and for administration of Makena (17-alpha hydroxyprogesterone). Subpar-
agraph (D) includes provision for visit with a physician, psychiatrist
or psychologist or licensed clinical social worker to provide services
for treatment of mental, nervous or emotional disorders and ailments for
assistance with emotional issues experienced by expectant mothers and
the family for expectant mothers who: lost a fetus through miscarriage
or stillbirth; lost a child within a month of birth; or diagnosed as
having experienced pre-term labor.
Section 2 amends item (i) of subparagraph (A) of paragraph 5 of
subsection (k) of section 3221 of the insurance law as amended by chap-
ter 238 of the laws of 2010 to include two new subparagraphs (C)and (D).
Adding expectant mothers in pre-term labor. Subparagraph (C) includes
provision for part-time or intermittent home nursing care by or under
the supervision of registered professional nurse to monitor expectant
mothers diagnosed by physicians as having experienced pre-term • labor;
and for administration of• Makena (17-alpha hydroxyprogesterone).
Subparagraph (D) includes provision for visit with a physician, psychia-
trist or psychologist or licensed clinical social worker to provide
services for treatment of mental, nervous or emotional disorders and
ailments for assistance with emotional issues experienced by expectant
mothers and the family for expectant mothers who: lost a fetus through
miscarriage or stillbirth; lost a child within a month of birth; or
diagnosed as having experienced pre-term labor.
Section 3 amends subparagraph (A) of paragraph 1 of subsection (c) of
section 4303 the insurance law as amended by chapter 238 of the laws of
2010 to include two new paragraphs 3 and 4. Adding expectant mothers in
pre-term labor. Paragraph 3 includes provision for part-time or inter-
mittent home nursing care by or under the supervision of registered
professional nurse to monitor expectant mothers diagnosed by physicians
as having experienced pre-term labor; and for administration of Makena
(17-alpha hydroxyprogesterone)". Paragraph 4 includes provision for
visit with a physician, psychiatrist or psychologist or licensed clin-
ical social worker to provide services for treatment of mental, nervous
or emotional disorders and ailments for assistance with emotional issues
experienced by expectant mothers and the family for expectant mothers
who: lost a fetus through miscarriage or stillbirth; lost a child within
a month of birth; or diagnosed as having experienced pre-term labor.
Section 4 This act shall take effect on the sixtieth day after it shall
have become a law. Effective immediately the addition, amendment and/or
repeal of any rule or regulation necessary for the implementation of
this act on its effective date are authorized to be made and completed
on or before such date.
JUSTIFICATION:
In October of 2016, Assemblymember Rodneyse Bichotte Hermelyn, pregnant
at 22 weeks, entered the New York Presbyterian/Columbia University
Medical Hospital after discovering she was dilating at 3cm. Hunched over
the hospital desk in emotional pain, awaiting to see the Doctor in the
examination room, she was soon to be notified of the worst news an
expectant mother can receive - both she and her unborn baby were in an
incredibly fatal and high risk situation. Knowing the risks associated
with Assemblymember Bichotte Hermelyn's condition, the Doctors at New
York Presbyterian Columbia University Hospital discharged and forcefully
released her citing "hospital policy". They claimed they could not
intervene-before 23-weeks and refused her a bed for monitoring at the
hospital. She was, therefore, denied the safe care of medical profes-
sionals to herself and her unborn child. Several days later, Assembly-
member Rodneyse Bichotte Hermelyn was admitted to Wyckoff Heights
Medical Center and delivered her still-born son, Jonah Bichotte Cowan.
Pre-term labor, a proxy of pre-term birth, accounts for 17% of all
infant deaths in America and devastates the growth of premature babies,
making them especially vulnerable to the environment. One in 10 families
across the country and New York State will face the same unfortunate
narrative of a high-risk pregnancy and mistreatment at the hands of
medical professionals. At such a sensitive stage in a woman's pregnancy,
health coverage for needed services should not be a factor.
This bill ensures that the care and treatment provided to expectant
mothers are covered by insurance carriers, and that they and their fami-
ly have access to services that assist with emotional issues experience
by the expectant mother.
PRIOR LEGISLATIVE HISTORY:
2021-22: A07492; referred to insurance
2019-20: A10314; referred to insurance
FISCAL IMPLICATIONS:
None
EFFECTIVE DATE:
This act shall take effect on the sixtieth day after it shall have
become a law. Effective immediately the addition, amendment and/or
repeal of any rule or regulation necessary for the implementation of
this act on its effective date are authorized to be made and completed
on or before such date.
STATE OF NEW YORK
________________________________________________________________________
1096
2023-2024 Regular Sessions
IN ASSEMBLY
January 13, 2023
___________
Introduced by M. of A. BICHOTTE HERMELYN, SILLITTI, STIRPE, COLTON,
CRUZ, JACKSON -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring insurance
policies to provide coverage for pre-term labor hospitalizations, home
visits to monitor pre-term labor patients and counseling
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Item (i) of subparagraph (A) of paragraph 10 of subsection
2 (i) of section 3216 of the insurance law, as amended by chapter 238 of
3 the laws of 2010, is amended and two new subparagraphs (C) and (D) are
4 added to read as follows:
5 (i) Every policy which provides hospital, surgical or medical coverage
6 shall provide coverage for maternity care, including hospital, surgical
7 or medical care to the same extent that hospital, surgical or medical
8 coverage is provided for illness or disease under the policy. Such
9 maternity care coverage, other than coverage for perinatal compli-
10 cations, shall include inpatient hospital coverage for expectant mothers
11 in pre-term labor, inpatient hospital coverage for mother and for
12 newborn for at least forty-eight hours after childbirth for any delivery
13 other than a caesarean section, and for at least ninety-six hours after
14 a caesarean section. Such coverage for maternity care shall include the
15 services of a midwife licensed pursuant to article one hundred forty of
16 the education law, practicing consistent with section sixty-nine hundred
17 fifty-one of the education law and affiliated or practicing in conjunc-
18 tion with a facility licensed pursuant to article twenty-eight of the
19 public health law, but no insurer shall be required to pay for duplica-
20 tive routine services actually provided by both a licensed midwife and a
21 physician.
22 (C) Coverage provided under this subsection for care and treatment
23 during pregnancy shall include provision for part-time or intermittent
24 home nursing care by or under the supervision of a registered profes-
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD01144-01-3
A. 1096 2
1 sional nurse to monitor expectant mothers who have been diagnosed by a
2 physician as having experienced pre-term labor, and for the adminis-
3 tration of Makena (17-alpha hydroxyprogesterone) by such nurse. As used
4 in this subsection, "pre-term labor" means the commencement of regular
5 contractions of the uterus causing palpable changes in the cervix that
6 start between twenty weeks and thirty-six weeks and six days of pregnan-
7 cy, including, but not limited to, effacement and dilation.
8 (D) Coverage provided under this subsection for care and treatment
9 during pregnancy shall include provisions for visits with a physician,
10 psychiatrist or psychologist or a licensed clinical social worker within
11 the lawful scope of his or her practice who provides psychiatric or
12 psychological services or for the diagnosis and treatment of mental,
13 nervous or emotional disorders and ailments for assistance with
14 emotional issues experienced by an expectant mother and the family of an
15 expectant mother who has:
16 (i) lost a fetus through miscarriage or stillbirth;
17 (ii) lost a child within a month after the birth of the child; or
18 (iii) been diagnosed by a physician as having experienced pre-term
19 labor.
20 § 2. Item (i) of subparagraph (A) of paragraph 5 of subsection (k) of
21 section 3221 of the insurance law, as amended by chapter 238 of the laws
22 of 2010, is amended and two new subparagraphs (C) and (D) are added to
23 read as follows:
24 (i) Every group or blanket policy delivered or issued for delivery in
25 this state which provides hospital, surgical or medical coverage shall
26 include coverage for maternity care, including hospital, surgical or
27 medical care to the same extent that coverage is provided for illness or
28 disease under the policy. Such maternity care coverage, other than
29 coverage for perinatal complications, shall include inpatient hospital
30 coverage for expectant mothers in pre-term labor, inpatient hospital
31 coverage for mother and newborn for at least forty-eight hours after
32 childbirth for any delivery other than a caesarean section, and for at
33 least ninety-six hours after a caesarean section. Such coverage for
34 maternity care shall include the services of a midwife licensed pursuant
35 to article one hundred forty of the education law, practicing consistent
36 with section sixty-nine hundred fifty-one of the education law and
37 affiliated or practicing in conjunction with a facility licensed pursu-
38 ant to article twenty-eight of the public health law, but no insurer
39 shall be required to pay for duplicative routine services actually
40 provided by both a licensed midwife and a physician.
41 (C) Coverage provided under this subsection for care and treatment
42 during pregnancy shall include provision for part-time or intermittent
43 home nursing care by or under the supervision of a registered profes-
44 sional nurse to monitor expectant mothers who have been diagnosed by a
45 physician as having experienced pre-term labor, and for the adminis-
46 tration of Makena (17-alpha hydroxyprogesterone) by such nurse. As used
47 in this subsection, "pre-term labor" means the commencement of regular
48 contractions of the uterus causing palpable changes in the cervix that
49 start between twenty weeks and thirty-six weeks and six days of pregnan-
50 cy, including, but not limited to, effacement and dilation.
51 (D) Coverage provided under this subsection for care and treatment
52 during pregnancy shall include provisions for visits with a physician,
53 psychiatrist or psychologist or a licensed clinical social worker within
54 the lawful scope of his or her practice who provides psychiatric or
55 psychological services or for the diagnosis and treatment of mental,
56 nervous or emotional disorders and ailments for assistance with
A. 1096 3
1 emotional issues experienced by an expectant mother and the family of an
2 expectant mother who has:
3 (i) lost a fetus through miscarriage or stillbirth;
4 (ii) lost a child within a month after the birth of the child; or
5 (iii) been diagnosed by a physician as having experienced pre-term
6 labor.
7 § 3. Subparagraph (A) of paragraph 1 of subsection (c) of section 4303
8 of the insurance law, as amended by chapter 238 of the laws of 2010, is
9 amended and two new paragraphs 3 and 4 are added to read as follows:
10 (A) Every contract issued by a corporation subject to the provisions
11 of this article which provides hospital service, medical expense indem-
12 nity or both shall provide coverage for maternity care including hospi-
13 tal, surgical or medical care to the same extent that hospital service,
14 medical expense indemnity or both are provided for illness or disease
15 under the contract. Such maternity care coverage, other than coverage
16 for perinatal complications, shall include inpatient hospital coverage
17 for expectant mothers in pre-term labor, inpatient hospital coverage for
18 mother and for newborn for at least forty-eight hours after childbirth
19 for any delivery other than a caesarean section, and for at least nine-
20 ty-six hours following a caesarean section. Such coverage for maternity
21 care shall include the services of a midwife licensed pursuant to arti-
22 cle one hundred forty of the education law, practicing consistent with
23 section sixty-nine hundred fifty-one of the education law and affiliated
24 or practicing in conjunction with a facility licensed pursuant to arti-
25 cle twenty-eight of the public health law, but no insurer shall be
26 required to pay for duplicative routine services actually provided by
27 both a licensed midwife and a physician.
28 (3) Coverage provided under this subsection for care and treatment
29 during pregnancy shall include provision for part-time or intermittent
30 home nursing care by or under the supervision of a registered profes-
31 sional nurse to monitor expectant mothers who have been diagnosed by a
32 physician as having experienced pre-term labor, and for the adminis-
33 tration of Makena (17-alpha hydroxyprogesterone) by such nurse. As used
34 in this subsection, "pre-term labor" means the commencement of regular
35 contractions of the uterus causing palpable changes in the cervix that
36 start between twenty weeks and thirty-six weeks and six days of pregnan-
37 cy, including, but not limited to, effacement and dilation.
38 (4) Coverage provided under this subsection for care and treatment
39 during pregnancy shall include provisions for visits with a physician,
40 psychiatrist or psychologist or a licensed clinical social worker within
41 the lawful scope of his or her practice who provides psychiatric or
42 psychological services or for the diagnosis and treatment of mental,
43 nervous or emotional disorders and ailments for assistance with
44 emotional issues experienced by an expectant mother and the family of an
45 expectant mother who has:
46 (A) lost a fetus through miscarriage or stillbirth;
47 (B) lost a child within a month after the birth of the child; or
48 (C) been diagnosed by a physician as having experienced pre-term
49 labor.
50 § 4. This act shall take effect on the sixtieth day after it shall
51 have become a law. Effective immediately the addition, amendment and/or
52 repeal of any rule or regulation necessary for the implementation of
53 this act on its effective date are authorized to be made and completed
54 on or before such date.
