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A03760 Summary:

BILL NO    A03760A

SAME AS    No same as 

SPONSOR    Espinal

COSPNSR    Jaffee, Rozic, Aubry, Rosa, Colton, Steck, Sepulveda, Abinanti,
           Borelli, Montesano, Graf, Cook, Skoufis, Scarborough, Moya, Perry,
           Titus

MLTSPNSR   Arroyo, Brennan, Clark, Jacobs, Magee, Ra, Rivera, Simanowitz,
           Sweeney, Titone, Weisenberg

Amd SS3216, 3221, 4303 & 4326, Ins L

Requires health insurance policies to cover comprehensive screening for ovarian
cancer.
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A03760 Actions:

BILL NO    A03760A

01/29/2013 referred to insurance
02/13/2013 amend (t) and recommit to insurance
02/13/2013 print number 3760a
11/20/2013 enacting clause stricken
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A03760 Text:

                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________

                                        3760--A

                              2013-2014 Regular Sessions

                                 I N  A S S E M B L Y

                                   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    S 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    S 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    S  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    S 5. This act shall take effect on the sixtieth  day  after  it  shall
   15  have become a law.
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