8/15/07 N.Y. St. Reg. INS-33-07-00004-P
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:
Proposed action:
Amendment of section 52.16(c)(5) (Regulation 62) of Title 11 NYCRR.
Statutory authority:
Insurance Law, sections 201, 301, 1109, 3201, 3216, 3217, 3221, 4235, 4303, 4304, 4305, 4802 and art. 49
Subject:
Minimum standards for the form, content and sale of health insurance.
Purpose:
To clarify when plans may exclude coverage for cosmetic surgery.
Text of proposed rule:
Paragraph (5) of subdivision (c) of Section 52.16 of Part 52 of Title 11 of the Official Compilation of Codes, Rules and Regulations is amended to read as follows:
(5) cosmetic surgery, except that cosmetic surgery shall not include reconstructive surgery when such service is incidental to or follows surgery resulting from trauma, infection or other diseases of the involved part, and reconstructive surgery because of congenital disease or anomaly of a covered dependent child which has resulted in a functional defect. However, if the policy provides hospital, surgical or medical expense coverage, including a policy issued by a health maintenance organization, then coverage and determinations with respect to cosmetic surgery must be provided pursuant to Part 56 of this Title (Regulation 183);
Text of proposed rule and any required statements and analyses may be obtained from:
Andrew Mais, Insurance Department, 25 Beaver St., New York, NY 10004, (212) 480-2285, e-mail:
amais@ins.state.ny.usData, views or arguments may be submitted to:
Lisette Johnson, Insurance Department, Health Bureau, One Commerce Plaza, Albany, NY 12257, (518) 474-4098, e-mail:
ljohnson@ins.state.ny.usPublic comment will be received until:
45 days after publication of this notice.
Regulatory Impact Statement
A regulatory impact statement is not submitted with this notice because this rule is subject to a consolidated regulatory impact statement that was previously printed under a notice of proposed rule making, I.D. No. INS-33-07-00003-P, Issue of August 15, 2007.
Regulatory Flexibility Analysis
A regulatory flexibility analysis is not submitted with this notice because this rule is subject to a consolidated regulatory flexibility analysis that was previously printed under a notice of proposed rule making, I.D. No. INS-33-07-00003-P, Issue of August 15, 2007.
Rural Area Flexibility Analysis
A rural area flexibility analysis is not submitted with this notice because this rule is subject to a consolidated rural area flexibility analysis that was previously printed under a notice of proposed rule making, I.D. No. INS-33-07-00003-P, Issue of August 15, 2007.
Job Impact Statement
A job impact statement is not submitted with this notice because this rule is subject to a consolidated job impact statement that was previously printed under a notice of proposed rule making, I.D. No. INS-33-07-00003-P, Issue of August 15, 2007.
