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NYSSPS Seeks Full Insurance Coverage for Congenital Anomalies

May 10, 2019 6:21 PM | Anonymous


NYSSPS is proud to announce that it is working to advance efforts in the state to address insurance coverage for congenital anomalies. With support from ASPS, the Society will educate the public and policymakers on the importance to expedite care for those impacted with by congenital anomalies and seek legislative and regulatory changes to the existing law. More information on how you can become involved will be released in the coming weeks. 

The 1in38 Campaign will focus it efforts on the following: 

Educate

One in 38 New York babies are born with a congenital anomaly.

Nationally, of the 120,000 children born annually with congenital anomalies, approximately 40,000 require reconstructive surgery. 

Although surgeons are able to correct many of these problems, some insurance companies deny or excessively delay access to care by labeling the procedures not medically necessary–“cosmetic,” or “non-functional” in nature.

Although carriers may provide coverage for initial procedures, they may resist coverage of the later stage procedures by claiming they are cosmetic and/or not medically necessary. 

Regulate

Proactively address delays and denials of coverage for procedures and therapies.

Legislate

Require all health insurance policies to cover medically necessary procedures and therapies.

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