A 11627: Relates to medical and dental coverage for the treatment of ameloblastoma which shall include but is not limited to dental implants and implant-related services.

  
  STATE OF NEW YORK ________________________________________________________________________ 11627  IN ASSEMBLY July 29, 2026 ___________ Introduced by COMMITTEE ON RULES -- (at request of M. of A. Paulin, Jensen) -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to coverage for the treatment of ameloblastoma 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 42 to read as follows: 3 (42) (A) Every policy which provides physician services, medical, 4 major medical or similar comprehensive-type coverage shall provide 5 coverage for medically necessary services for the treatment of amelob- 6 lastoma, which shall include but not be limited to dental implants and 7 implant-related services for insureds who have experienced tooth loss or 8 removal as part of treatment for ameloblastoma. 9 (B) Every policy which provides coverage or reimbursement for dental 10 services shall provide coverage or reimbursement for medically necessary 11 dental services for the treatment of ameloblastoma, which shall include 12 but not be limited to dental implants and implant-related services for 13 insureds who have experienced tooth loss or removal as part of treatment 14 for ameloblastoma. 15 (C) Nothing in this paragraph shall be construed to prevent coverage 16 for those who have been diagnosed with ameloblastoma prior to the enact- 17 ment of this paragraph and are seeking dental implants and implant-re- 18 lated services due to tooth loss or removal caused by ameloblastoma. 19 § 2. Subsection (l) of section 3221 of the insurance law is amended by 20 adding a new paragraph 24 to read as follows: 21 (24) (A) Every group or blanket policy delivered or issued for deliv- 22 ery in this state which provides major medical or similar comprehen- 23 sive-type coverage shall provide coverage for medically necessary 24 services for the treatment of ameloblastoma, which shall include but not 25 be limited to dental implants and implant-related services for insureds 26 who have experienced tooth loss or removal as part of treatment for 27 ameloblastoma. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD16067-03-6 
 A. 11627 2 1 (B) Every group or blanket policy delivered or issued for delivery in 2 this state which provides coverage or reimbursement for dental services 3 shall provide coverage or reimbursement for medically necessary dental 4 services for the treatment of ameloblastoma, which shall include but not 5 be limited to dental implants and implant-related services for insureds 6 who have experienced tooth loss or removal as part of treatment for 7 ameloblastoma. 8 (C) Nothing in this paragraph shall be construed to prevent coverage 9 for those who have been diagnosed with ameloblastoma prior to the enact- 10 ment of this paragraph and are seeking dental implants and implant-re- 11 lated services due to tooth loss or removal caused by ameloblastoma. 12 § 3. Section 4303 of the insurance law is amended by adding a new 13 subsection (yy) to read as follows: 14 (yy) (1) Every medical expense indemnity corporation, hospital service 15 corporation and health service corporation which provides major medical 16 or similar comprehensive-type coverage shall provide coverage for 17 medically necessary services for the treatment of ameloblastoma, which 18 shall include but not be limited to dental implants and implant-related 19 services for insureds who have experienced tooth loss or removal as part 20 of treatment for ameloblastoma. 21 (2) Every medical expense indemnity corporation, hospital service 22 corporation and health service corporation which provides coverage or 23 reimbursement for dental services shall provide coverage or reimburse- 24 ment for medically necessary dental services for the treatment of 25 ameloblastoma, which shall include but not be limited to dental implants 26 and implant-related services for insureds who have experienced tooth 27 loss or removal as part of treatment for ameloblastoma. 28 (3) Nothing in this subsection shall be construed to prevent coverage 29 for those who have been diagnosed with ameloblastoma prior to the enact- 30 ment of this subsection and are seeking dental implants and implant-re- 31 lated services due to tooth loss or removal caused by ameloblastoma. 32 § 4. This act shall take effect immediately and shall apply to poli- 33 cies and contracts issued, renewed, modified, altered or amended on or 34 after such effective date.