Requires health insurance policies and medicaid to cover biomarker testing for diagnosis, treatment, appropriate management, or ongoing monitoring of a covered person's disease or condition when the test is supported by medical and scientific evidence.
Requires health insurers to provide coverage for procedures relating to the diagnosis and treatment of uterine fibroids and related conditions, including pain, discomfort and infertility resulting therefrom.
Requires health insurance policies to offer full coverage for annual testing for ovarian cancer; requires certain health care providers offer annual testing for ovarian cancer.
Requires a utilization review agent to follow certain rules when establishing a step therapy protocol; requires that the protocol accepts any attestation submitted by the insured's health care professional stating that a required drug has failed as prima facie evidence that the required drug has failed.
Provides that the New York state health care quality and cost containment commission shall: evaluate each mandated benefit; investigate current practices of health plans with regard to the mandated benefit; investigate the potential premium impact of repealing and/or modifying the mandated benefits on all segments of the insurance market; hold at least two public hearings; and submit a report to the legislature; makes related provisions.
Requires actuarial certification of certain rate determinations made by the superintendent, in accordance with practice standards established by the actuarial standards board.
Provides for coverage of hearing aids for child patients who are covered under a policy or contract of insurance if the hearing aids are fitted and dispensed by a licensed audiologist certified by the American Speech-Language-Hearing Association following medical clearance by a physician licensed to practice medicine and an audiological evaluation medically appropriate to the age of the child.
Relates to reimbursement for ambulance services; requires insurers to submit payments directly to ambulance providers who are in-network or, for out-of-network ambulance providers, requires the issuance of a joint check to the insured specifying both the insured and the ambulance provider as payees.
Requires all motor vehicle insurers to file annual detailed financial and claim data statements with the superintendent of financial services; provides that all such statements shall be made available to the public.