In September 2014 New York Governor Cuomo signed into law a bill (S7893 in the Senate/A10140 in the Assembly) that requires all major commercial medical insurance policies to cover the provision of ostomy supplies. The bill, which was introduced by Senator Valesky and Assemblyman Magnarelli, and will take effect on January 1, 2015.
The legislation states that "every policy which provides medical coverage that includes coverage for physician services in a physician's office and every policy which provides major medical or similar comprehensive-type coverage shall include coverage for equipment and supplies used for the treatment of ostomies." The coverage will be subject to annual deductibles and coinsurance.
Two states down, many more to go!
This makes New York only the second state to pass such legislation, Connecticut statue has been in effect for over ten years. The United Ostomy Associations of America (UOAA) and many others have spent much time working on the passing of this important bill, and it’s taken over two and a half years to reach this joyful outcome.
There is a long list of individuals who contributed to this accomplishment. Here are some of the people who contributed significant time and effort: Wound, Ostomy and Continence Nurses Heidi Cross, Jody Scardillo, Donna Truland, and Vasti Livingstone; UOAA Consultant Colin Cooke; and the introducing legislators Senator Valesky and Assemblyman Magnarelli.
In addition, there were many organizations who provided support, including: Wound, Ostomy and Continence Nurses Society™ (WOCN®), UOAA support groups in the New York area, Crohn's and Colitis Foundation of America, New York Medical Equipment Providers Association, American Cancer Society, Convatec Inc., and Hollister Corp.
There's one exception to the rule. This additional message was added by UOAA Consultant, Colin Cooke, on October 12, 2014, “You will note that in the above I refer to commercial health insurance, and that is because the law does not apply to those that are run and funded by the state. However, as it stands there is now only one ‘state’ health insurance plan that does not cover ostomy supplies and that, surprisingly, is Child Health Plus. We are now trying to persuade those who administer the plan to include ostomy supplies. If any of you have any information regarding anyone who has a child with an ostomy and who is covered by that program, it would be a great help if you could let me have any details you have or put their parents in touch with me. We feel we could well be successful here, but only if we can come up with real examples of problems or hardship resulting from non-coverage by this program. Thank you for all your support and please help us to close the last gap in coverage in the state of New York.”
WOCN goes above and beyond the call of duty.
Many WOCN® Society members in New York devoted themselves to ensuring this legislation was enacted. Without their willpower, this legislation would have likely stayed inactive, as in previous years. The importance of this law will make a huge difference in the lives of people living with an ostomy.
This legislation marks an important first step in our effort to protect our patient’s rights to the medical supplies that they so desperately need. The WOCN Society looks forward to building on the momentum gained in New York and would ask each of you to consider taking up a similar cause in your state. — Becky Dryden, WOCN® Society