NY A07793

Mandates health insurance coverage for treatment of congenital anomalies including reconstructive services, habilitative services, and inpatient/outpatient care for missing or abnormal body parts, excluding cosmetic surgery.

Requires coverage for dental, orthodontic, and prosthodontic support from birth until medical or surgical treatment of the anomaly is completed, including ongoing treatment to maintain function or approximate normal appearance.

Prohibits insurers from denying eligibility, enrollment, or renewal solely to avoid these coverage requirements and forbids penalizing providers for complying with the mandate.

Requires expedited internal appeal process for coverage denials, with oral decision within 48 hours and written confirmation within 7 days.

Applies to all health insurance policies, plans, certificates, and contracts issued, renewed, modified, altered, or amended on or after January 1 following enactment.