S 10208 NY
Relates to insurance coverage for pediatric acute-onset neuropsychiatric syndrome
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Summary
This bill requires health insurance policies in New York to cover rehabilitation treatment for pediatric acute-onset neuropsychiatric syndrome. Coverage must be provided when an attending physician certifies in writing that the rehabilitative treatment is medically necessary for a participant or beneficiary. The requirement applies to health plans and health insurance issuers offering coverage in connection with group health plans. The bill defines pediatric acute-onset neuropsychiatric syndrome using the same definition found in New York's Public Health Law. The bill takes effect January 1 following enactment and applies to policies issued, renewed, modified, altered, or amended on or after that date.
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Official abstract
Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.
Sponsor (1)
- Pete Harckham Democratic · primary
2 coauthors / cosponsors
- Dan Stec Republican · cosponsor
- April Baskin Democratic · cosponsor
Action history (1)
- May 5, 2026 REFERRED TO INSURANCE · upper
Text versions (2)
Full text
Full text imported from assembly.state.ny.us
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Bill No.: Summary Actions Committee Votes Floor Votes Memo Text LFIN Chamber Video/Transcript S10208 Summary: BILL NO S10208   SAME AS SAME AS A09659-A
  SPONSOR HARCKHAM   COSPNSR STEC, BASKIN   MLTSPNSR   Amd §§3216, 3221 & 4303, Ins L   Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.
Go to top S10208 Text:
STATE OF NEW YORK ________________________________________________________________________
10208
IN SENATE
May 5, 2026 ___________
Introduced by Sens. HARCKHAM, STEC -- read twice and ordered printed, and when printed to be committed to the Committee 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 (yy) to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06726-05-6
S. 10208 2
1 (yy)(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.
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