S 8550: Requires certain health insurance plans cover electrocardiograms for adults and children who have received a coronavirus vaccine regardless of family history of heart disease or conditions.

  
  STATE OF NEW YORK ________________________________________________________________________ 8550 2025-2026 Regular Sessions  IN SENATE October 24, 2025 ___________ Introduced by Sen. WEIK -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the insurance law and the social services law, in relation to requiring certain health insurance plans cover electrocar- diograms for adults and children who have received a coronavirus vaccine The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Items (iii), (iv) and (v) of subparagraph (E) of paragraph 2 17 of subsection (i) of section 3216 of the insurance law, items (iii) 3 and (iv) as amended by chapter 219 of the laws of 2011 and item (v) as 4 amended by section 3 of part M of chapter 57 of the laws of 2019, are 5 amended and a new item (vi) is added to read as follows: 6 (iii) with respect to children, including infants and adolescents, 7 evidence-informed preventive care and screenings provided for in compre- 8 hensive guidelines supported by the health resources and services admin- 9 istration; [and] 10 (iv) with respect to women, such additional preventive care and 11 screenings not described in item (i) of this subparagraph and as 12 provided for in comprehensive guidelines supported by the health 13 resources and services administration[.]; 14 (v) all FDA-approved contraceptive drugs, devices, and other products, 15 including all over-the-counter contraceptive drugs, devices, and 16 products as prescribed or as otherwise authorized under state or federal 17 law; voluntary sterilization procedures pursuant to 42 U.S.C. 18022 and 18 identified in the comprehensive guidelines supported by the health 19 resources and services administration and thereby incorporated in the 20 essential health benefits benchmark plan; patient education and coun- 21 seling on contraception; and follow-up services related to the drugs, 22 devices, products, and procedures covered under this [clause] item, 23 including, but not limited to, management of side effects, counseling EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13556-02-5 
 S. 8550 2 1 for continued adherence, and device insertion and removal. Except as 2 otherwise authorized under this [clause] item, a contract shall not 3 impose any restrictions or delays on the coverage required under this 4 [clause] item. However, where the FDA has approved one or more therapeu- 5 tic and pharmaceutical equivalent, as defined by the FDA, versions of a 6 contraceptive drug, device, or product, a contract is not required to 7 include all such therapeutic and pharmaceutical equivalent versions in 8 its formulary, so long as at least one is included and covered without 9 cost-sharing and in accordance with this [clause] item. If the covered 10 therapeutic and pharmaceutical equivalent versions of a drug, device, or 11 product are not available or are deemed medically inadvisable a contract 12 shall provide coverage for an alternate therapeutic and pharmaceutical 13 equivalent version of the contraceptive drug, device, or product without 14 cost-sharing. (a) This coverage shall include emergency contraception 15 without cost sharing when provided pursuant to a prescription, or order 16 under section sixty-eight hundred thirty-one of the education law or 17 when lawfully provided over-the-counter. (b) If the attending health 18 care provider, in [his or her] such provider's reasonable professional 19 judgment, determines that the use of a non-covered therapeutic or phar- 20 maceutical equivalent of a drug, device, or product is warranted, the 21 health care provider's determination shall be final. The superintendent 22 shall promulgate regulations establishing a process, including time- 23 frames, for an insured, an insured's designee or an insured's health 24 care provider to request coverage of a non-covered contraceptive drug, 25 device, or product. Such regulations shall include a requirement that 26 insurers use an exception form that shall meet criteria established by 27 the superintendent. (c) This coverage must allow for the dispensing of 28 up to twelve months worth of a contraceptive at one time. (d) For the 29 purposes of this [clause] item, "over-the-counter contraceptive 30 products" shall mean those products provided for in comprehensive guide- 31 lines supported by the health resources and services administration as 32 of January twenty-first, two thousand nineteen[.]; and 33 (vi) with respect to adults and children who have received a coronavi- 34 rus vaccine, an electrocardiogram test and an interpretation of the 35 results of such test, regardless of whether such adults and children 36 have a family history of heart disease or conditions, if ordered by a 37 physician or other licensed professional whose scope of practice under 38 title eight of the education law provides the authority to administer 39 such a test, in accordance with prevailing clinical standards. 40 § 2. Items (iii) and (iv) of subparagraph (E) of paragraph 8 of 41 subsection (l) of section 3221 of the insurance law, as amended by chap- 42 ter 219 of the laws of 2011, are amended and a new item (v) is added to 43 read as follows: 44 (iii) with respect to children, including infants and adolescents, 45 evidence-informed preventive care and screenings provided for in compre- 46 hensive guidelines supported by the health resources and services admin- 47 istration; [and] 48 (iv) with respect to women, such additional preventive care and 49 screenings not described in item (i) of this subparagraph and as 50 provided for in comprehensive guidelines supported by the health 51 resources and services administration[.]; and 52 (v) with respect to adults and children who have received a coronavi- 53 rus vaccine, an electrocardiogram test and an interpretation of the 54 results of such test, regardless of whether such adults and children 55 have a family history of heart disease or conditions, if ordered by a 56 physician or other licensed professional whose scope of practice under 
 S. 8550 3 1 title eight of the education law provides the authority to administer 2 such a test, in accordance with prevailing clinical standards. 3 § 3. Subparagraphs (C) and (D) of paragraph 3 of subsection (j) of 4 section 4303 of the insurance law, as added by chapter 219 of the laws 5 of 2011, are amended and a new subparagraph (E) is added to read as 6 follows: 7 (C) with respect to children, including infants and adolescents, 8 evidence-informed preventive care and screenings provided for in compre- 9 hensive guidelines supported by the health resources and services admin- 10 istration; [and] 11 (D) with respect to women, such additional preventive care and screen- 12 ings not described in subparagraph (A) of this paragraph and as provided 13 for in comprehensive guidelines supported by the health resources and 14 services administration[.]; and 15 (E) with respect to adults and children who have received a coronavi- 16 rus vaccine, an electrocardiogram test and an interpretation of the 17 results of such test, regardless of whether such adults and children 18 have a family history of heart disease or conditions, if ordered by a 19 physician or other licensed professional whose scope of practice under 20 title eight of the education law provides the authority to administer 21 such a test, in accordance with prevailing clinical standards. 22 § 4. Subdivision 2 of section 365-a of the social services law is 23 amended by adding a new paragraph (t-1) to read as follows: 24 (t-1) with respect to adults and children who have received a corona- 25 virus vaccine, an electrocardiogram test and an interpretation of the 26 results of such test, regardless of whether such adults and children 27 have a family history of heart disease or conditions, if ordered by a 28 physician or other licensed professional whose scope of practice under 29 title eight of the education law provides the authority to administer 30 such a test, in accordance with prevailing clinical standards; provided, 31 however, that the provisions of this paragraph relating to electrocardi- 32 ogram tests shall not take effect unless all necessary approvals under 33 federal law and regulation have been obtained to receive federal finan- 34 cial participation in the costs of such services. 35 § 5. This act shall take effect immediately and shall apply to any 36 policy issued, delivered, renewed, and/or modified on or after the 37 effective date of this act.