STATE OF NEW YORK ________________________________________________________________________ 7790--A 2023-2024 Regular Sessions IN ASSEMBLY June 15, 2023 ___________ Introduced by M. of A. SOLAGES, BICHOTTE HERMELYN -- read once and referred to the Committee on Insurance -- recommitted to the Committee on Insurance in accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, in relation to expanding coverage requirements for human donor milk The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph 38 of subsection (i) of section 3216 of the 2 insurance law, as added by section 10 of part MM of chapter 57 of the 3 laws of 2018 and as renumbered by chapter 739 of the laws of 2022, is 4 amended to read as follows: 5 (38) Every policy that provides coverage for hospital, surgical or 6 medical care shall provide the following coverage for pasteurized donor 7 human milk (PDHM), which may include fortifiers as medically indicated[, 8 for inpatient use], for which a licensed medical practitioner has issued 9 an order for an infant who is medically or physically unable to receive 10 maternal breast milk or participate in breast feeding or whose mother is 11 medically or physically unable to produce maternal breast milk at all or 12 in sufficient quantities or participate in breast feeding despite opti- 13 mal lactation support. Such infant shall: (i) have a documented birth 14 weight of less than one thousand five hundred grams; or (ii) have a 15 congenital or acquired condition that places the infant at a high risk 16 for development of necrotizing enterocolitis. 17 § 2. Paragraph 20 of subsection (l) of section 3221 of the insurance 18 law, as added by section 11 of part MM of chapter 57 of the laws of 19 2018, is amended to read as follows: 20 (20) Every insurer delivering a group or blanket policy or issuing a 21 group or blanket policy for delivery in this state that provides cover- 22 age for hospital, surgical or medical care shall provide the following EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD11129-03-4
A. 7790--A 2 1 coverage for pasteurized donor human milk (PDHM), which may include 2 fortifiers as medically indicated[, for inpatient use], for which a 3 licensed medical practitioner has issued an order for an infant who is 4 medically or physically unable to receive maternal breast milk or 5 participate in breast feeding or whose mother is medically or physically 6 unable to produce maternal breast milk at all or in sufficient quanti- 7 ties or participate in breast feeding despite optimal lactation support. 8 Such infant shall: (i) have a documented birth weight of less than one 9 thousand five hundred grams; or (ii) have a congenital or acquired 10 condition that places the infant at a high risk for development of 11 necrotizing enterocolitis. 12 § 3. Subsection (oo) of section 4303 of the insurance law, as added by 13 section 12 of part MM of chapter 57 of the laws of 2018, is amended to 14 read as follows: 15 (oo) A medical expense indemnity corporation, a hospital service 16 corporation or a health service corporation that provides coverage for 17 hospital, surgical or medical care shall provide the following coverage 18 for pasteurized donor human milk (PDHM), which may include fortifiers as 19 medically indicated[, for inpatient use], for which a licensed medical 20 practitioner has issued an order for an infant who is medically or phys- 21 ically unable to receive maternal breast milk or participate in breast 22 feeding or whose mother is medically or physically unable to produce 23 maternal breast milk at all or in sufficient quantities or participate 24 in breast feeding despite optimal lactation support. Such infant shall: 25 (i) have a documented birth weight of less than one thousand five 26 hundred grams; or (ii) have a congenital or acquired condition that 27 places the infant at a high risk for development of necrotizing entero- 28 colitis. 29 § 4. This act shall take effect on the first of January next succeed- 30 ing the date on which it shall have become a law and shall apply to all 31 policies issued, renewed, modified, altered or amended on or after such 32 date. Effectively immediately, the addition, amendment and/or repeal of 33 any rule or regulation necessary for the implementation of this act on 34 its effective date are authorized to be made and completed on or before 35 such date.