BILL NUMBER: S868
SPONSOR: BAILEY
 
TITLE OF BILL:
An act to amend the insurance law, in relation to requiring certain
health insurance policies to include coverage for the cost of certain
infant and baby formulas
 
PURPOSE:
To allow parents to affordably provide medically necessary formulas for
infants who would become malnourished or suffer from disorders if said
formulas are not made available to them. These disorders, if left
untreated, may cause chronic physical disability, mental disability, or
death.
 
SUMMARY OF SPECIFIC PROVISIONS:
The bill would require that any policy which provides coverage for
prescription drugs shall also provide coverage for the cost of infant
and baby formulas which are proven effective as a disease-specific regi-
men. Such formulas must be prescribed by a physician or other licensed
healthcare professional. Coverage for certain infant and baby formulas
for any twelve months shall not be less than $3000.
 
JUSTIFICATION:
Many infants are prescribed medically necessary formulas which have
proven effective as a part of a disease-specific treatment regimen for
malnourishment or who would suffer from disorders which, if left
untreated, may cause chronic physical disability, mental disability, or
death. Specific diseases for which infant formulas have proven effective
include inherited diseases relating to amino acids; Crohn's disease;
gastroesophageal reflux with failure to thrive; and multiple, severe
food allergies. Symptoms of such allergies may include loose stools
containing blood; vomiting; hives; diarrhea; abdominal cramps; coughing
or wheezing; runny nose; watery eyes; itchy skin rash, often around the
mouth; and colic.
Infant and baby formulas, which must be purchased to prevent symptoms
from occurring, are often more expensive than regular formulas. Espe-
cially during these difficult economic times, parents need help to
provide the food that is best and safest for their infants. Currently,
in New York State, insurance companies are not required to cover these
medically necessary formulas. However, other states, such as Arizona,
Colorado, Louisiana, and Massachusetts do have provisions requiring
insurance companies to cover such infant formulas.
 
LEGISLATIVE HISTORY:
2017-18: Referred to Insurance
2019-20: Referred to Insurance
2021-22: Referred to Insurance
2023-24: Referred to Insurance
 
EFFECTIVE DATE:
The first of January next succeeding the date it becomes a law, with
provisions.

Statutes affected:
S868: 3216 insurance law, 3216(i) insurance law, 3221 insurance law, 3221(k) insurance law, 4303 insurance law, 4303(y) insurance law, 4322 insurance law, 4322(b) insurance law