A 2695: Requires certain health insurance plans cover annual electrocardiograms for covered children under the age of nineteen.

  
  STATE OF NEW YORK ________________________________________________________________________ 2695 2025-2026 Regular Sessions  IN ASSEMBLY January 22, 2025 ___________ Introduced by M. of A. DURSO -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law and the social services law, in relation to requiring certain health insurance plans cover annual electrocardiograms for covered children under the age of nineteen The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Clauses (ii) and (iii) of subparagraph (B) of paragraph 17 2 of subsection (i) of section 3216 of the insurance law, as amended by 3 chapter 219 of the laws of 2011, are amended and a new clause (iv) is 4 added to read as follows: 5 (ii) at each visit, services in accordance with the prevailing clin- 6 ical standards of such designated association, including a medical 7 history, a complete physical examination, developmental assessment, 8 anticipatory guidance, appropriate immunizations and laboratory tests 9 which tests are ordered at the time of the visit and performed in the 10 practitioner's office, as authorized by law, or in a clinical laborato- 11 ry; [and] 12 (iii) necessary immunizations, as determined by the superintendent in 13 consultation with the commissioner of health, consisting of at least 14 adequate dosages of vaccine against diphtheria, pertussis, tetanus, 15 polio, measles, rubella, mumps, haemophilus influenzae type b and hepa- 16 titis b, which meet the standards approved by the United States public 17 health service for such biological products[.]; and 18 (iv) an electrocardiogram test and an interpretation of the results of 19 such test at least once annually and with greater frequency if ordered 20 by a physician or other licensed professional whose scope of practice 21 under title eight of the education law provides the authority to admin- 22 ister such a test, in accordance with prevailing clinical standards. 23 § 2. Clauses (ii) and (iii) of subparagraph (B) of paragraph 8 of 24 subsection (l) of section 3221 of the insurance law, as amended by chap- 25 ter 219 of the laws of 2011, are amended and a new clause (iv) is added 26 to read as follows: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD05728-01-5 
 A. 2695 2 1 (ii) at each visit, services in accordance with the prevailing clin- 2 ical standards of such designated association, including a medical 3 history, a complete physical examination, developmental assessment, 4 anticipatory guidance, appropriate immunizations and laboratory tests 5 which tests are ordered at the time of the visit and performed in the 6 practitioner's office, as authorized by law, or in a clinical laborato- 7 ry; [and] 8 (iii) necessary immunizations, as determined by the superintendent in 9 consultation with the commissioner of health, consisting of at least 10 adequate dosages of vaccine against diphtheria, pertussis, tetanus, 11 polio, measles, rubella, mumps, haemophilus influenzae type b and hepa- 12 titis b, which meet the standards approved by the United States public 13 health service for such biological products[.]; and 14 (iv) an electrocardiogram test and an interpretation of the results of 15 such test at least once annually and with greater frequency if ordered 16 by a physician or other licensed professional whose scope of practice 17 under title eight of the education law provides the authority to admin- 18 ister such a test, in accordance with prevailing clinical standards. 19 § 3. Subparagraphs (B) and (C) of paragraph 2 of subsection (j) of 20 section 4303 of the insurance law, as amended by chapter 219 of the laws 21 of 2011, are amended and a new subparagraph (C-1) is added to read as 22 follows: 23 (B) at each visit, services in accordance with the prevailing clinical 24 standards of such designated association, including a medical history, a 25 complete physical examination, developmental assessment, anticipatory 26 guidance, appropriate immunizations and laboratory tests which tests are 27 ordered at the time of the visit and performed in the practitioner's 28 office, as authorized by law, or in a clinical laboratory, [and] 29 (C) necessary immunizations, as determined by the superintendent in 30 consultation with the commissioner of health, consisting of at least 31 adequate dosages of vaccine against diphtheria, pertussis, tetanus, 32 polio, measles, rubella, mumps, haemophilus influenzae type b and hepa- 33 titis b, which meet the standards approved by the United States public 34 health service for such biological products[.], and 35 (C-1) an electrocardiogram test and an interpretation of the results 36 of such test at least once annually and with greater frequency if 37 ordered by a physician or other licensed professional whose scope of 38 practice under title eight of the education law provides the authority 39 to administer such a test, in accordance with prevailing clinical stand- 40 ards. 41 § 4. Subdivision 2 of section 365-a of the social services law is 42 amended by adding a new paragraph (t-1) to read as follows: 43 (t-1) screening, including an electrocardiogram test and interpreta- 44 tion of the results of such test in children eighteen years of age or 45 under, at least once annually and with greater frequency if ordered by a 46 physician or other licensed professional whose scope of practice under 47 title eight of the education law provides the authority to administer 48 such a test and if done in accordance with prevailing clinical stand- 49 ards; provided, however, that the provisions of this paragraph relating 50 to electrocardiogram tests shall not take effect unless all necessary 51 approvals under federal law and regulation have been obtained to receive 52 federal financial participation in the costs of such services. 53 § 5. This act shall take effect immediately and shall apply to any 54 policy issued, delivered, renewed, and/or modified on or after the 55 effective date of this act.