S 2655 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 the costs of rehabilitation treatment for pediatric acute-onset neuropsychiatric syndrome (PANS) for participants and beneficiaries. Coverage is required when the attending physician certifies in writing that the proposed rehabilitative treatment is medically necessary. 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 by reference to the definition in Public Health Law section 207. The bill takes effect on January 1 following enactment and applies to policies, contracts, and certificates issued, renewed, modified, altered, or amended on or after that date.
AI-generated plain-language summary of the bill text — neutral, and may be imperfect. See the full text below for the exact wording.
Official abstract
Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.
Sponsor (1)
- Dan Stec Republican · primary
3 coauthors / cosponsors
- Patrick M. Gallivan Republican · cosponsor
- Joseph A. Griffo Republican · cosponsor
- Peter Oberacker Republican · cosponsor
Action history (5)
- Jan 22, 2025 REFERRED TO INSURANCE · upper
- Jan 7, 2026 REFERRED TO INSURANCE · upper
- Jan 16, 2026 AMEND AND RECOMMIT TO INSURANCE · upper
- Jan 16, 2026 PRINT NUMBER 2655A · upper
- May 4, 2026 RECOMMIT, ENACTING CLAUSE STRICKEN · upper
Text versions (3)
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 S02655 Summary: BILL NO S02655A   SAME AS SAME AS A09659
  SPONSOR STEC   COSPNSR GALLIVAN, GRIFFO, OBERACKER   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 S02655 Text:
STATE OF NEW YORK ________________________________________________________________________
2655--A
2025-2026 Regular Sessions
IN SENATE
January 22, 2025 ___________
Introduced by Sens. STEC, GALLIVAN, GRIFFO, OBERACKER -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- recommitted to the Committee on Insurance in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
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.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06726-03-6
S. 2655--A 2
1 (B) As used in this paragraph, the term "pediatric acute-onset neurop- 2 sychiatric syndrome" shall have the same meaning as such term is used in 3 paragraph (n) of subdivision one of section two hundred seven of the 4 public health law. 5 § 3. Section 4303 of the insurance law is amended by adding a new 6 subsection (xx) to read as follows: 7 (xx)(1) Every health plan, and health insurance issuer offering health 8 insurance coverage in connection with a group health plan, shall provide 9 coverage for a participant or beneficiary who has pediatric acute-onset 10 neuropsychiatric syndrome if the attending physician of the participant 11 or beneficiary certifies in writing the medical necessity of that 12 proposed course of rehabilitative treatment. 13 (2) As used in this subsection, the term "pediatric acute-onset 14 neuropsychiatric syndrome" shall have the same meaning as such term is 15 used in paragraph (n) of subdivision one of section two hundred seven of 16 the public health law. 17 § 4. This act shall take effect on the first of January next succeed- 18 ing the date on which it shall have become a law and shall apply accord- 19 ing to its terms to all policies, contracts and certificates issued, 20 renewed, modified, altered or amended on or after such effective date.
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