BILL NUMBER: S2397 Revised 1/23/2025
SPONSOR: PERSAUD
 
TITLE OF BILL:
An act to amend the insurance law, in relation to requiring health
insurers to provide coverage for diagnosis and treatment of fibroids
 
PURPOSE OR GENERAL IDEA OF BILL:
This bill would amend subsection (i) of 3216 of the insurance laws to
add a new paragraph 36 that states that all insurance companies cover
the cost of coverage for the treatment, symptoms, and diagnosis of
fibroids and infertility that may have been caused by fibroids.
 
SUMMARY OF PROVISIONS:
Section 1: Amends subsection (i) of section 3216 of the insurance law,
to require all insurance companies to cover costs for uterine fibroids.
Section 2 amends subsection (k) of section 3221 of the insurance law to
require every group or blanket policy to provide coverage for uterine
fibroids. Section 3 amends section 4303 of the insurance law to add
subsection (ss) which requires every medical expense indemnity corpo-
ration, hospital service, and health service corporation to provide
coverage for uterine fibroids.
 
JUSTIFICATION:
Currently, in New York State, there is no mandate that requires all
insurance companies to provide coverage for the diagnosis and/or treat-
ment of fibroids. Fibroids are usually only covered if they are causing
the patient pain or other symptoms. Some insurance companies will only
cover fibroid removal or hysterectomy when symptoms have not gone away.
This means that for people who have fibroids that are not yet causing
them pain or are seeking experimental treatments related to fibroids
their care may not be covered by health insurance. Many insurances will
only partially cover the procedure leaving patients with large copays to
fully cover the cost.
This legislation addresses the gap in insurance coverage regarding
fibroids. It would require insurance companies and other entities that
provide insurance coverage to provide coverage for all costs of diagno-
sis, symptoms, and treatment of uterine fibroids. It would also cover
infertility that was caused by fibroids. Many women do not seek treat-
ment for fibroids because they are worried it may not be covered by
insurance or that their specific treatment will not be covered by insur-
ance. This legislation would allow women with fibroids to seek treatment
without the worry that it will not be covered by their insurance provid-
er.
 
PRIOR LEGISLATIVE HISTORY:
2023/2024: 51194 Referred to Insurance
2022: S8549 Referred to Insurance
 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
To be determined
 
EFFECTIVE DATE:
This Act shall take effect on the one hundred twentieth day after enact-
ment.

Statutes affected:
S2397: 3216 insurance law, 3216(i) insurance law, 3221 insurance law, 3221(k) insurance law, 4303 insurance law