A 622: Requires mandatory health insurance coverage for acupuncture services upon the prescription of a health care provider acting within the provider's scope of practice.

  
  STATE OF NEW YORK ________________________________________________________________________ 622 2025-2026 Regular Sessions  IN ASSEMBLY (Prefiled) January 8, 2025 ___________ Introduced by M. of A. KIM, COLTON, EPSTEIN, LUCAS, REYES, CHANG, STERN -- read once and referred to the Committee on Insurance AN ACT to amend the insurance law, in relation to mandatory health insurance coverage for acupuncture services 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) Every policy issued within the health benefit exchange estab- 4 lished pursuant to section 1311 of the affordable care act, 42 U.S.C. § 5 18031, shall provide coverage for acupuncture treatment as defined in 6 section eight thousand two hundred eleven of the education law provided 7 by an individual licensed, authorized, or certified pursuant to article 8 one hundred sixty of the education law. However, acupuncture treatment 9 and services may be subject to reasonable deductible, co-payment and 10 co-insurance amount, reasonable fee or benefit limits, and reasonable 11 utilization review, provided that any such amounts, limits or review 12 shall be no greater than other essential health benefits covered by the 13 policy and provided further that any such amounts, limits, or review 14 shall not function to direct treatment in a manner discriminative 15 against acupuncture treatment. Nothing herein shall be construed as 16 impending or preventing either the provision or coverage of acupuncture 17 treatment and services by duly licensed or certified acupuncturist, 18 within the lawful scope of the practice of acupuncture, in hospital 19 facilities on a staff or employee basis. 20 § 2. Section 4303 of the insurance law is amended by adding a new 21 subsection (ww) to read as follows: 22 (ww) Every policy issued within the health benefit exchange estab- 23 lished pursuant to section 1311 of the affordable care act, 42 U.S.C. § 24 18031, shall provide coverage for acupuncture treatment as defined in EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00185-01-5 
 A. 622 2 1 section eight thousand two hundred eleven of the education law provided 2 by an individual licensed, authorized, or certified pursuant to article 3 one hundred sixty of the education law. However, acupuncture treatment 4 and services may be subject to reasonable deductible, co-payment and 5 co-insurance amount, reasonable fee or benefit limits, and reasonable 6 utilization review, provided that any such amounts, limits or review 7 shall be no greater than other essential health benefits covered by the 8 policy and provided further that any such amounts, limits, or review 9 shall not function to direct treatment in a manner discriminative 10 against acupuncture treatment. Nothing herein shall be construed as 11 impeding or preventing either the provision or coverage of acupuncture 12 treatment and services by duly licensed or certified acupuncturists, 13 within the lawful scope of the practice of acupuncture, in hospital 14 facilities on a staff or employees basis. 15 § 3. This act shall take effect on the ninetieth day after it shall 16 have become a law and shall apply to policies and contracts issued, 17 renewed, modified, altered or amended on or after such effective date.