New York Assembly Bill A05444 Latest Draft

   
  STATE OF NEW YORK ________________________________________________________________________ 5444 2025-2026 Regular Sessions  IN ASSEMBLY February 14, 2025 ___________ Introduced by M. of A. ROSENTHAL -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to coverage for perimeno- pausal and menopausal care and treatment The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subsection (i) of section 3216 of the insurance law is 2 amended by adding a new paragraph 40 to read as follows: 3 (40) (A) Every policy that provides coverage for hospital, surgical or 4 medical care shall provide coverage for perimenopausal and menopausal 5 care and treatment administered by a physician or other licensed health 6 care provider. Symptoms of menstrual complications for perimenopausal 7 and menopausal care authorized under this paragraph include, but are not 8 limited to: irregular menstrual periods, hot flashes, chills, slowed 9 metabolism, vaginal or bladder problems, decrease in fertility, loss of 10 bone, increase in low-density lipoprotein cholesterol levels, and sleep 11 disruption including night sweats. 12 (B) For purposes of subparagraph (A) of this paragraph: 13 (i) "Menopause" means the permanent cessation of menstruation due to 14 loss of ovarian follicular function, where ovaries stop releasing eggs 15 and the body produces less estrogen and progesterone. 16 (ii) "Perimenopause" means the transition period in which a woman is 17 near the end of her reproductive years or at the onset of menopause. 18 (C) Such coverage required pursuant to subparagraph (A) of this para- 19 graph may be subject to annual deductibles and coinsurance as may be 20 deemed appropriate by the superintendent and as are consistent with 21 those established for other benefits within a given policy. 22 § 2. Subsection (k) of section 3221 of the insurance law is amended by 23 adding a new paragraph 24 to read as follows: 24 (24)(A) Every policy that provides coverage for hospital, surgical or 25 medical care shall provide coverage for perimenopausal and menopausal EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD01048-01-5 
 A. 5444 2 1 care or treatment administered by a physician or other licensed health 2 care provider. Symptoms of menstrual complications for perimenopausal 3 and menopausal care authorized under this paragraph include, but are not 4 limited to: irregular menstrual periods, hot flashes, chills, slowed 5 metabolism, vaginal or bladder problems, decrease in fertility, loss of 6 bone, increase in low-density lipoprotein cholesterol levels, and sleep 7 disruption including night sweats. 8 (B) For purposes of subparagraph (A) of this paragraph: 9 (i) "Menopause" means the permanent cessation of menstruation due to 10 loss of ovarian follicular function, where ovaries stop releasing eggs 11 and the body produces less estrogen and progesterone. 12 (ii) "Perimenopause" means the transition period in which a woman is 13 near the end of her reproductive years or at the onset of menopause. 14 (C) Such coverage required pursuant to subparagraph (A) of this para- 15 graph may be subject to annual deductibles and coinsurance as may be 16 deemed appropriate by the superintendent and as are consistent with 17 those established for other benefits within a given policy. 18 § 3. Section 4303 of the insurance law is amended by adding a new 19 subsection (ww) to read as follows: 20 (ww)(1) Any contract issued by a medical expense indemnity corpo- 21 ration, a hospital service corporation or a health services corporation 22 that provides coverage for hospital, surgical or medical care shall 23 provide coverage for perimenopausal and menopausal care or treatment 24 administered by a physician or other licensed health care provider. 25 Symptoms of menstrual complications for perimenopausal and menopausal 26 care authorized under this paragraph include, but are not limited to: 27 irregular menstrual periods, hot flashes, chills, slowed metabolism, 28 vaginal or bladder problems, decrease in fertility, loss of bone, 29 increase in low-density lipoprotein cholesterol levels, and sleep 30 disruption including night sweats. 31 (2) For purposes of paragraph one of this subsection: 32 (A) "Menopause" means the permanent cessation of menstruation due to 33 loss of ovarian follicular function, where ovaries stop releasing eggs 34 and the body produces less estrogen and progesterone. 35 (B) "Perimenopause" means the transition period in which a woman is 36 near the end of her reproductive years or at the onset of menopause. 37 (3) Such coverage required pursuant to paragraph one of this 38 subsection may be subject to annual deductibles and coinsurance as may 39 be deemed appropriate by the superintendent and as are consistent with 40 those established for other benefits within a given contract. 41 § 4. This act shall take effect on the first of January next succeed- 42 ing the date on which it shall have become a law and shall apply to 43 policies issued, reissued, renewed, modified or amended on or after such 44 date.