A 9659: Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

  
  STATE OF NEW YORK ________________________________________________________________________ 9659  IN ASSEMBLY January 21, 2026 ___________ Introduced by M. of A. CASHMAN -- read once and referred to the Commit- tee on Insurance AN ACT to amend the insurance law, in relation to requiring certain health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome 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 health plan, and health insurance issuer offering health 4 insurance coverage in connection with a group health plan, shall provide 5 coverage for a participant or beneficiary who has pediatric acute-onset 6 neuropsychiatric syndrome if the attending physician of the participant 7 or beneficiary certifies in writing the medical necessity of that 8 proposed course of rehabilitative treatment. 9 (B) As used in this paragraph, the term "pediatric acute-onset neurop- 10 sychiatric syndrome" shall have the same meaning as such term is used in 11 paragraph (n) of subdivision one of section two hundred seven of the 12 public health law. 13 § 2. Subsection (k) of section 3221 of the insurance law is amended by 14 adding a new paragraph 24 to read as follows: 15 (24) (A) Every health plan, and health insurance issuer offering 16 health insurance coverage in connection with a group health plan, shall 17 provide coverage for a participant or beneficiary who has pediatric 18 acute-onset neuropsychiatric syndrome if the attending physician of the 19 participant or beneficiary certifies in writing the medical necessity of 20 that proposed course of rehabilitative treatment. 21 (B) As used in this paragraph, the term "pediatric acute-onset neurop- 22 sychiatric syndrome" shall have the same meaning as such term is used in 23 paragraph (n) of subdivision one of section two hundred seven of the 24 public health law. 25 § 3. Section 4303 of the insurance law is amended by adding a new 26 subsection (xx) to read as follows: EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06726-02-6 
 A. 9659 2 1 (xx)(1) Every health plan, and health insurance issuer offering health 2 insurance coverage in connection with a group health plan, shall provide 3 coverage for a participant or beneficiary who has pediatric acute-onset 4 neuropsychiatric syndrome if the attending physician of the participant 5 or beneficiary certifies in writing the medical necessity of that 6 proposed course of rehabilitative treatment. 7 (2) As used in this subsection, the term "pediatric acute-onset 8 neuropsychiatric syndrome" shall have the same meaning as such term is 9 used in paragraph (n) of subdivision one of section two hundred seven of 10 the public health law. 11 § 4. This act shall take effect on the first of January next succeed- 12 ing the date on which it shall have become a law and shall apply accord- 13 ing to its terms to all policies, contracts and certificates issued, 14 renewed, modified, altered or amended on or after such effective date.