Women’s
Health & Wellness Act
New York State employers who provide prescription drug coverage to employees must now offer insurance coverage for contraceptive drugs and devices. A new law, called the Women’s Health & Wellness Act, also requires employers to expand coverage for prevention, early detection and treatment of breast and cervical cancer and the bone density-thinning condition called osteoporosis.
Religious
or faith-based organizations can be exempted from offering contraceptive
coverage under the law only if they primarily employ and serve members of that
faith. The exemption does not apply to contraceptive drugs that are prescribed
for medical reasons other than contraception. As with all state mandated health
benefits, the law does not apply to employers with self-insured plans.
In addition
to requiring coverage for contraceptive drugs and devices (not including
over-the-counter products), the new law:
·
Lets women see an
obstetrician/gynecologist for two exams a year, plus pregnancy care, without
referral from a primary-care physician
·
Requires coverage
of preventive bone-density exams; and
·
Expands coverage
for mammograms and screening for cervical cancer (PAP smears) to include
employers who were formerly exempted, and requires coverage for annual
mammograms beginning at age 40.
The HMOs
participating in the New York State Health Insurance Program (NYSHIP), as well
as the Empire Plan have already been providing coverage for many of the services
included in the Women’s Health & Wellness Act. As a result, the law will
result in few changes for most NYSHIP enrollees. The HMOs mailed letters to
their members in November 2002 notifying them of any benefit changes from last
year to this year. Members enrolled in the Empire Plan will be notified shortly
of the benefit changes resulting from the new law (see
chart) and the date these changes take effect.