STATE OF NEW YORK ________________________________________________________________________ 419 2025-2026 Regular Sessions IN ASSEMBLY (Prefiled) January 8, 2025 ___________ Introduced by M. of A. R. CARROLL -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to requiring certain insurance policies to cover neuropsychological exams for dyslexia The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Paragraph 39 of subsection (i) of section 3216 of the 2 insurance law, as added by a chapter of the laws of 2024 amending the 3 insurance law relating to requiring certain insurance policies to cover 4 neuropsychological exams for dyslexia, as proposed in legislative bills 5 numbers S. 5481-A and A. 2898-A, is amended to read as follows: 6 [(39)] (40) (A) Every policy that provides coverage for physician 7 services, medical, major medical or similar comprehensive-type coverage 8 shall, upon the referral of a physician, provide coverage for [testing] 9 comprehensive neuropsychological examinations for [suspected] dyslexia 10 when performed by a health care professional licensed, certified, or 11 authorized pursuant to title eight of the education law and acting with- 12 in their scope of practice and in accordance with this paragraph and 13 shall not exclude coverage for the screening, diagnosis or treatment of 14 medical conditions otherwise covered by the policy. 15 (B) [Coverage shall include comprehensive neuropsychological examina- 16 tions for the purposes of diagnosing dyslexia and determining the 17 psychological, emotional, and educational wellness needs of the individ- 18 ual tested.] Nothing in this paragraph shall be construed to prevent the 19 medical management or utilization review of the services or prevent a 20 policy from requiring that services be provided through a network of 21 participating providers. 22 § 2. Subsection (u) of section 3221 of the insurance law, as added by 23 a chapter of the laws of 2024 amending the insurance law relating to 24 requiring certain insurance policies to cover neuropsychological exams EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD02832-01-5
A. 419 2 1 for dyslexia, as proposed in legislative bills numbers S. 5481-A and A. 2 2898-A, is amended to read as follows: 3 (u) (1) Every policy that provides coverage for physician services, 4 medical, major medical or similar comprehensive-type coverage shall, 5 upon the referral of a physician, provide coverage for [testing] compre- 6 hensive neuropsychological examinations for [suspected] dyslexia when 7 performed by a health care professional licensed, certified, or author- 8 ized pursuant to title eight of the education law and acting within 9 their scope of practice and in accordance with this subsection and shall 10 not exclude coverage for the screening, diagnosis or treatment of 11 medical conditions otherwise covered by the policy. 12 (2) [Coverage shall include comprehensive neuropsychological examina- 13 tions for the purposes of diagnosing dyslexia and determining the 14 psychological, emotional, and educational wellness needs of the individ- 15 ual tested.] Nothing in this subsection shall be construed to prevent 16 the medical management or utilization review of the services or prevent 17 a policy from requiring that services be provided through a network of 18 participating providers. 19 § 3. Subsection (vv) of section 4303 of the insurance law, as added by 20 a chapter of the laws of 2024 amending the insurance law relating to 21 requiring certain insurance policies to cover neuropsychological exams 22 for dyslexia, as proposed in legislative bills numbers S. 5481-A and A. 23 2898-A, is amended to read as follows: 24 (vv) (1) Every [policy] contract that provides coverage for physician 25 services, medical, major medical or similar comprehensive-type coverage 26 shall, upon the referral of a physician, provide coverage for [testing] 27 comprehensive neuropsychological examinations for [suspected] dyslexia 28 when performed by a health care professional licensed, certified, or 29 authorized pursuant to title eight of the education law and acting with- 30 in their scope of practice and in accordance with this subsection and 31 shall not exclude coverage for the screening, diagnosis or treatment of 32 medical conditions otherwise covered by the [policy] contract. 33 (2) [Coverage shall include comprehensive neuropsychological examina- 34 tions for the purposes of diagnosing dyslexia and determining the 35 psychological, emotional, and educational wellness needs of the individ- 36 ual tested.] Nothing in this subsection shall be construed to prevent 37 the medical management or utilization review of the services or prevent 38 a contract from requiring that services be provided through a network of 39 participating providers. 40 § 4. This act shall take effect on the same date and in the same 41 manner as a chapter of the laws of 2024 amending the insurance law 42 relating to requiring certain insurance policies to cover neuropsycho- 43 logical exams for dyslexia, as proposed in legislative bills numbers S. 44 5481-A and A. 2898-A, takes effect.