NY A03833

Requires health insurance policies with physician office coverage or major medical coverage to cover diagnosis and medically necessary treatment (surgical and nonsurgical) for musculoskeletal disorders affecting bones or joints in the face, neck, or head resulting from accident, trauma, congenital defect, developmental defect, or pathology.

Coverage must be equivalent to coverage provided for other musculoskeletal disorders in the body and may be administered by physicians or dentists.

Excludes coverage for dental services related to dental disorders or dental pathology primarily affecting gums, teeth, or alveolar ridge.

Applies to individual policies under section 3216, group/blanket policies under section 3221, and hospital/medical service corporations under section 4303.

Takes effect January 1 following enactment and applies to all policies issued, renewed, altered, or modified on or after that date; referral from contracted health care provider may be required.