Bill > S06474

This bill, named "Give Kids a Chance - Carter's Law," mandates comprehensive health insurance coverage for children with congenital anomalies, which are medically diagnosed conditions existing at or from birth that deviate from the body's typical structure or function. The legislation requires insurance policies to provide coverage for reconstructive and habilitative services for dependent children, including treatments for conditions like cleft lip/palate, webbed fingers, cranial malformations, and other diagnosed congenital anomalies. Key provisions include requiring insurers to cover inpatient and outpatient services that improve body function or appearance, such as prosthetics, dental support, and follow-up treatments, without categorizing these as cosmetic surgery. The bill also establishes an expedited appeal process for denied claims, requiring health plans to respond to appeals within 48 hours orally and provide written confirmation within seven days. Insurance carriers are prohibited from denying coverage or penalizing healthcare providers for treating these conditions, and must provide written notice of these coverage options to participants annually. The law will take effect on the first day of January following its enactment and will apply to all new, renewed, or modified insurance policies from that date forward.

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https://www.nysenate.gov/legislation/bills/2025/S6474