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Bill

A 10030

Requires health insurers to provide coverage for speech therapy for stuttering

2025 Regular Session Introduced by Sam Berger and 1 co-sponsor

The bill requires health insurers to cover all costs of speech therapy for stuttering, with no annual or durational limits, when prescribed by a physician.

AMENDED ON THIRD READING 10030B
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WeVote Research Nonpartisan
Bill Summary · A 10030

Summary of Bill A. 10030-A (2025-2026) – New York

Overview

  • Title: Requires health insurers to provide coverage for speech therapy for stuttering
  • Jurisdiction: New York
  • Sponsor(s): Assembly Members Weprin (lead) and Sam Berger
  • Status: Amended on Third Reading (as of April 16, 2026); previously advanced through committees and floor actions
  • Effective date: January 1 next succeeding the date it becomes law; applies to policies issued, renewed, modified, altered, or amended on or after that date. Immediate rulemaking authorization for implementation.

Purpose and Intent

The bill mandates coverage for speech therapy for stuttering by certain health insurance plans, ensuring treatment costs are covered when prescribed by a physician. It aims to remove financial barriers to habilitative and rehabilitative speech therapy for individuals who stutter.

Key Provisions

Section 1 – Insurance Law (paragraph 24 added to Subsection (k) of §3221)

  • Applies to: Group or blanket policies delivering in-state coverage for medical, major medical, or similar comprehensive-type coverage.
  • Coverage requirement: Upon physician referral, insurers must cover all costs for speech therapy for stuttering. This includes habilitative and rehabilitative speech therapy performed by a licensed health care professional (licensed under Title 8 of the Education Law).
  • Benefit limits: No durational benefit limitation or maximum for benefits, services, or visits for speech therapy for stuttering.
  • Safeguards:
    • Medical management/utilization review may still apply.
    • Policies may require treatment to be provided through a network of participating providers.
    • Coverage may be denied if the therapy is provided under an Individualized Family Service Plan (IFSP) under Public Health Law §2545 or an Individualized Education Plan (IEP) under Education Law Article 89. However, services provided under an IFSP/IEP do not affect coverage for services provided on a supplemental basis outside of an educational setting if referred by a physician.

Section 2 – Insurance Law (§4303) Added Subsection (yy)

  • Applies to: Medical expense indemnity corporations, hospital service corporations, and health service corporations offering medical/major medical/comprehensive-type coverage.
  • Coverage requirement: Upon physician referral, insurers must cover all costs for speech therapy for stuttering (habilitation and rehabilitation) provided by a licensed health care professional (Title 8). No durational limit or maximum for benefits, services, or visits.
  • Safeguards:
    • Medical management/utilization review may apply.
    • Policies may require services to be provided through a network of participating providers.
    • Coverage may be denied if therapy is provided under an IFSP (Public Health Law §2545) or an IEP (Education Law Article 89). Coverage for services provided outside an educational setting, with physician referral, remains subject to policy terms.

Who Is Affected

  • Health insurers offering medical, major medical, or similar comprehensive-type coverage in New York (including group/blanket policies and medical expense indemnity/hospital/health service corporations).
  • Beneficiaries: Policyholders and insured individuals who receive a physician referral for speech therapy for stuttering.
  • Providers: Licensed speech-language pathologists and other licensed health professionals under Title 8 of the Education Law.

Timing and Implementation

  • Effective date: Not explicitly stated beyond the act taking effect on January 1 of the year after enactment (common “first day of January next succeeding” phrasing). Applies to policies issued, renewed, modified, or amended on or after that date.
  • Rulemaking: Immediate authorization for necessary rule or regulation changes to implement the act on its effective date.

Practical Impact

  • Increases financial protection for individuals receiving speech therapy for stuttering by eliminating annual/durational limits for covered services.
  • Aligns coverage with physician-directed care and professional licensure requirements.
  • Could influence patient access to therapy, reduce out-of-pocket costs, and potentially improve treatment outcomes for people who stutter.

If you’d like, I can provide a comparison with current NY insurance rules on speech therapy coverage or a one-page explainer for patients and providers.

Compiled from official sources — confirm details with the bill’s official record.

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