STATE OF NEW YORK
________________________________________________________________________
3760--A
2013-2014 Regular Sessions
IN ASSEMBLY
January 29, 2013
___________
Introduced by M. of A. ESPINAL, JAFFEE -- read once and referred to the
Committee on Insurance -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee
AN ACT to amend the insurance law, in relation to requiring health
insurance policies to cover comprehensive tests for ovarian cancer in
certain cases
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Paragraph 7 of subsection (d) of section 4326 of the
2 insurance law, as added by chapter 1 of the laws of 1999, is amended to
3 read as follows:
4 (7) adult preventive health services consisting of mammography screen-
5 ing; ovarian cancer screening as provided in subsection (p-1) of section
6 four thousand three hundred three of this article; cervical cytology
7 screening; periodic physical examinations no more than once every three
8 years; and adult immunizations;
9 § 2. Subsection (i) of section 3216 of the insurance law is amended by
10 adding a new paragraph 11-b to read as follows:
11 (11-b) (A) Every policy that provides coverage for hospital, surgical
12 or medical care shall provide the following coverage for screening for
13 ovarian cancer:
14 (i) upon the recommendation of a physician, a pelvic exam, genetic
15 testing, ultrasound and blood testing at any age for covered persons
16 having a high risk of developing ovarian cancer or who have a first
17 degree relative with a prior history of ovarian cancer;
18 (ii) a single baseline ultrasound for covered persons aged thirty-five
19 through thirty-nine, inclusive; and
20 (iii) an annual ultrasound for covered persons aged forty and older.
21 (B) Such coverage required pursuant to subparagraph (A) of this para-
22 graph may be subject to annual deductibles and coinsurance as may be
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD06910-03-3
A. 3760--A 2
1 deemed appropriate by the superintendent and as are consistent with
2 those established for other benefits within a given policy.
3 (C) (i) Such policy shall provide for additional coverage for computed
4 tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-
5 tron emission tomography, laparoscopy, colonoscopy and biopsy if a
6 person is believed to be at increased risk for ovarian cancer due to
7 family history or prior personal history of ovarian cancer, positive
8 genetic testing or other indications as determined by such person's
9 physician or nurse practitioner.
10 (ii) Such additional coverage may be subject to annual deductibles and
11 coinsurance as may be deemed appropriate by the superintendent and as
12 are consistent with those established for other benefits within a given
13 policy.
14 § 3. Subsection (1) of section 3221 of the insurance law is amended by
15 adding a new paragraph 11-b to read as follows:
16 (11-b) (A) Every insurer delivering a group or blanket policy or issu-
17 ing a group or blanket policy for delivery in this state that provides
18 coverage for hospital, surgical or medical care shall provide the
19 following coverage for screening for ovarian cancer:
20 (i) upon the recommendation of a physician, a pelvic exam, genetic
21 testing, ultrasound and blood testing at any age for covered persons
22 having a high risk of developing ovarian cancer or who have a first
23 degree relative with a prior history of ovarian cancer;
24 (ii) a single baseline ultrasound for covered persons aged thirty-five
25 through thirty-nine, inclusive; and
26 (iii) an annual ultrasound for covered persons aged forty and older.
27 (B) Such coverage required pursuant to subparagraph (A) of this para-
28 graph may be subject to annual deductibles and coinsurance as may be
29 deemed appropriate by the superintendent and as are consistent with
30 those established for other benefits within a given policy.
31 (C) (i) Such policy shall provide for additional coverage for computed
32 tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-
33 tron emission tomography, laparoscopy, colonoscopy and biopsy if a
34 person is believed to be at increased risk for ovarian cancer due to
35 family history or prior personal history of ovarian cancer, positive
36 genetic testing or other indications as determined by such person's
37 physician or nurse practitioner.
38 (ii) Such additional coverage may be subject to annual deductibles and
39 coinsurance as may be deemed appropriate by the superintendent and as
40 are consistent with those established for other benefits within a given
41 policy.
42 § 4. Section 4303 of the insurance law is amended by adding a new
43 subsection (p-1) to read as follows:
44 (p-1) (1) A medical expense indemnity corporation, a hospital service
45 corporation or a health service corporation that provides coverage for
46 hospital, surgical or medical care shall provide the following coverage
47 for screening for ovarian cancer:
48 (A) upon the recommendation of a physician, a pelvic exam, genetic
49 testing, ultrasound and blood testing at any age for covered persons
50 having a high risk of developing ovarian cancer or who have a first
51 degree relative with a prior history of ovarian cancer;
52 (B) a single baseline ultrasound for covered persons aged thirty-five
53 through thirty-nine, inclusive; and
54 (C) an annual ultrasound for covered persons aged forty and older.
55 (2) Such coverage required pursuant to subparagraph (A) of this para-
56 graph may be subject to annual deductibles and coinsurance as may be
A. 3760--A 3
1 deemed appropriate by the superintendent and as are consistent with
2 those established for other benefits within a given policy.
3 (3) (A) Such policy shall provide for additional coverage for computed
4 tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-
5 tron emission tomography, laparoscopy, colonoscopy and biopsy if a
6 person is believed to be at increased risk for ovarian cancer due to
7 family history or prior personal history of ovarian cancer, positive
8 genetic testing or other indications as determined by such person's
9 physician or nurse practitioner.
10 (B) Such additional coverage may be subject to annual deductibles and
11 coinsurance as may be deemed appropriate by the superintendent and as
12 are consistent with those established for other benefits within a given
13 policy.
14 § 5. This act shall take effect on the sixtieth day after it shall
15 have become a law.
