NY A02384

Requires health insurance policies to cover medically necessary services from any provider chosen by the patient for rare diseases, life-threatening conditions, degenerative and disabling conditions, or medically fragile children, regardless of whether the provider is in-network

Coverage applies when the chosen provider's costs are equal to or less than what would be paid to a local in-network provider with similar subspecialty expertise

Patients must obtain a written recommendation from their treating specialist or primary care provider, and provide advance notice to their insurance plan before planned procedures

Chosen providers must be accredited by the Department of Health, federal government, or national health organization as having special expertise, or demonstrate clinical focus in treating the specific diagnosis

Insurers are not required to cover travel costs to out-of-network providers, and the chosen provider does not need to be located within New York State