BILL NUMBER: S3100
SPONSOR: RIVERA
 
TITLE OF BILL:
An act to amend the social services law and the insurance law, in
relation to coverage for the treatment of asthma
 
PURPOSE:
To ensure that every health insurance policy includes coverage for the
equipment and supplies for the treatment of asthma and for additional
equipment and supplies for use in school if recommended or prescribed to
children under nineteen years of age.
 
SUMMARY OF PROVISIONS:
Section 1 amends paragraph (r) of subdivision 2 of section 365-a of the
Social Services Law, as it relates to asthma self-management training,
to include self-management training services for persons or parents of
those diagnosed with asthma, including information and proper use of
devices and triggers in environments that should be avoided in standard
coverage for asthma.
Section 2 amends subsection (i) of section 3216 of the Insurance Law, as
it relates to individual accident and health insurance policy provisions
providing coverage of the treatment of asthma, to require every health
insurance policy to provide medical coverage for equipment and supplies
for the treatment of asthma. Additionally, the Commissioner of the
Department of Health (COH) would provide and periodically update the
list of asthma equipment and medical supplies necessary for the treat-
ment of asthma.
Section 3 amends subsection (k) of section 3221 of the Insurance Law, as
it relates to group or blanket accident and health insurance policies
providing coverage for the treatment of asthma, to require every health
insurance policy would provide medical coverage for equipment and
supplies for the treatment of asthma. Additionally, the DOH would
provide and periodically update the list of asthma equipment and medical
supplies necessary for the treatment of asthma.
Section 4 provides an effective date.
 
EXISTING LAW:
The insurance law already provides similar provisions requiring coverage
of equipment and supplies for the treatment of diabetes.
 
JUSTIFICATION:
Asthma is a chronic disease of the lungs that causes wheezing, breath-
lessness, chest tightness, and coughing. It is the most common chronic
disease among children and adolescents, affecting approximately 4.6
million children, and is a leading reason for school absenteeism in the
USA (REF1, REF2). The asthma burden in New York State is notably higher,
with a prevalence of 6.8% compared to the national average of 7.7%
(REF), impacting around 315,000 children (REF). A recent report from the
New York State Department of Health indicates that the burden of asthma
is higher in New York City compared to New York State, with the Bronx
experiencing particularly elevated rates of emergency department (ED)
visits and age-adjusted asthma mortality. The data also reveal stark
sociodemographic and racial disparities, with significantly higher asth-
ma occurrence and associated ED visits among low-income Black and
Hispanic individuals (REF).
Asthma-related ED visits and hospitalizations are frequently associated
with poor asthma management, including incorrect use of inhaler medica-
tions due to confusion in identifying the correct inhaler, lack of
education on proper inhaler and device usage, and poor medication adher-
ence (REF, REF). Studies show up to 93% of asthma patients use their
inhaler medication incorrectly (REF, REF). Effective self-management
education and improved medication adherence among diagnosed adolescents
have been shown to reduce the disease burden, hospitalizations, ED
visits, and school absenteeism. Some programs have reported a return on
investment of $11.2 per $1 spent (REF, REF), highlighting the critical
need for robust asthma management programs. This was echoed by experts
in a roundtable discussion on asthma held by the Senate Health and Envi-
ronmental Conservation Committees in 2019 in the Bronx. A similar
conclusion was reached in an analysis conducted by the New York State
Department of Health, published in January 2023, in response to Article
VII, Part MM of the SFY 2018-2019 State Budget (REF). A key barrier to
effective asthma management and medication adherence is the cost of
medications and lack of adequate insurance coverage (REF, REF). This
issue was prominently discussed in the 2019 roundtable discussion, where
participants highlighted the need for insurance companies to cover the
cost of essential equipment and supplies for asthma treatment. Among the
recommendations was the inclusion of life-saving devices, such as rescue
inhalers, nebulizers, spacers, valves holding chambers, and masks, which
are critical for children to manage their asthma both at school and at
home. The roundtable participants also emphasized the challenges in
obtaining these devices from insurers, as well as the lack of proper
education and guidance from healthcare professionals on their correct
usage.
By ensuring insurance coverage for critical asthma treatment devices and
improving access to proper education on their usage, this bill has the
potential to significantly reduce asthma-related hospitalizations, emer-
gency department visits, and school absenteeism. It is an important step
toward alleviating the burden of asthma in New York, particularly in
communities facing high rates of asthma and related disparities. Invest-
ing in comprehensive asthma care, as outlined in this bill, will not
only improve the quality of life for affected individuals but also
result in long-term health and economic benefits for the state.
 
LEGISLATIVE HISTORY:
2019-2020: S7336/A10086 Reyes - Advanced to Third Reading.
2021-2022: S4934 Rivera/A2452 Reyes - Advanced to Third Reading.
2023-2024: S4889/A9826 Reyes - Passed Senate.
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
January 1st next succeeding enactment and shall apply to all policies
issued, renewed, altered, or modified on or after such date.

Statutes affected:
S3100: 365-a social services law, 365-a(2) social services law, 3216 insurance law, 3216(i) insurance law, 3221 insurance law, 3221(k) insurance law