S05373 Summary:

BILL NO    S05373 

SAME AS    SAME AS A08473

SPONSOR    SAVINO

COSPNSR    AVELLA

MLTSPNSR   

Amd SS3216, 3221 & 4303, Ins L

Requires health insurance policies to cover comprehensive screening for ovarian
cancer.
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S05373 Actions:

BILL NO    S05373 

05/16/2013 REFERRED TO INSURANCE
01/08/2014 REFERRED TO INSURANCE
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S05373 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          5373
 
                               2013-2014 Regular Sessions
 
                    IN SENATE
 
                                      May 16, 2013
                                       ___________
 
        Introduced  by  Sen.  SAVINO -- read twice and ordered printed, and when
          printed to be committed to the Committee on Insurance
 
        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.  Subsection  (i)  of  section 3216 of the insurance law is
     2  amended by adding a new paragraph 11-b to read as follows:
     3    (11-b) (A) Every policy that provides coverage for hospital,  surgical
     4  or  medical  care shall provide the following coverage for screening for
     5  ovarian cancer:
     6    (i) upon the recommendation of a physician,  a  pelvic  exam,  genetic
     7  testing,  ultrasound  and  blood  testing at any age for covered persons
     8  having a high risk of developing ovarian cancer  or  who  have  a  first
     9  degree relative with a prior history of ovarian cancer;
    10    (ii) a single baseline ultrasound for covered persons aged thirty-five

    11  through thirty-nine, inclusive; and
    12    (iii) an annual ultrasound for covered persons aged forty and older.
    13    (B)  Such coverage required pursuant to subparagraph (A) of this para-
    14  graph may be subject to annual deductibles and  coinsurance  as  may  be
    15  deemed  appropriate  by  the  superintendent  and as are consistent with
    16  those established for other benefits within a given policy.
    17    (C) (i) Such policy shall provide for additional coverage for computed
    18  tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-
    19  tron emission tomography,  laparoscopy,  colonoscopy  and  biopsy  if  a
    20  person  is  believed  to  be at increased risk for ovarian cancer due to
    21  family history or prior personal history  of  ovarian  cancer,  positive

    22  genetic  testing  or  other  indications  as determined by such person's
    23  physician or nurse practitioner.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD06910-04-3

        S. 5373                             2
 
     1    (ii) Such additional coverage may be subject to annual deductibles and
     2  coinsurance as may be deemed appropriate by the  superintendent  and  as
     3  are  consistent with those established for other benefits within a given
     4  policy.
     5    § 2. Subsection (1) of section 3221 of the insurance law is amended by
     6  adding a new paragraph 11-b to read as follows:

     7    (11-b) (A) Every insurer delivering a group or blanket policy or issu-
     8  ing  a  group or blanket policy for delivery in this state that provides
     9  coverage for hospital,  surgical  or  medical  care  shall  provide  the
    10  following coverage for screening for ovarian cancer:
    11    (i)  upon  the  recommendation  of a physician, a pelvic exam, genetic
    12  testing, ultrasound and blood testing at any  age  for  covered  persons
    13  having  a  high  risk  of  developing ovarian cancer or who have a first
    14  degree relative with a prior history of ovarian cancer;
    15    (ii) a single baseline ultrasound for covered persons aged thirty-five
    16  through thirty-nine, inclusive; and
    17    (iii) an annual ultrasound for covered persons aged forty and older.

    18    (B) Such coverage required pursuant to subparagraph (A) of this  para-
    19  graph  may  be  subject  to annual deductibles and coinsurance as may be
    20  deemed appropriate by the superintendent  and  as  are  consistent  with
    21  those established for other benefits within a given policy.
    22    (C) (i) Such policy shall provide for additional coverage for computed
    23  tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-
    24  tron  emission  tomography,  laparoscopy,  colonoscopy  and  biopsy if a
    25  person is believed to be at increased risk for  ovarian  cancer  due  to
    26  family  history  or  prior  personal history of ovarian cancer, positive
    27  genetic testing or other indications  as  determined  by  such  person's
    28  physician or nurse practitioner.

    29    (ii) Such additional coverage may be subject to annual deductibles and
    30  coinsurance  as  may  be deemed appropriate by the superintendent and as
    31  are consistent with those established for other benefits within a  given
    32  policy.
    33    §  3.  Section  4303  of  the insurance law is amended by adding a new
    34  subsection (p-1) to read as follows:
    35    (p-1) (1) A medical expense indemnity corporation, a hospital  service
    36  corporation  or  a health service corporation that provides coverage for
    37  hospital, surgical or medical care shall provide the following  coverage
    38  for screening for ovarian cancer:
    39    (A)  upon  the  recommendation  of a physician, a pelvic exam, genetic
    40  testing, ultrasound and blood testing at any  age  for  covered  persons

    41  having  a  high  risk  of  developing ovarian cancer or who have a first
    42  degree relative with a prior history of ovarian cancer;
    43    (B) a single baseline ultrasound for covered persons aged  thirty-five
    44  through thirty-nine, inclusive; and
    45    (C) an annual ultrasound for covered persons aged forty and older.
    46    (2)  Such coverage required pursuant to subparagraph (A) of this para-
    47  graph may be subject to annual deductibles and  coinsurance  as  may  be
    48  deemed  appropriate  by  the  superintendent  and as are consistent with
    49  those established for other benefits within a given policy.
    50    (3) (A) Such policy shall provide for additional coverage for computed
    51  tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-

    52  tron emission tomography,  laparoscopy,  colonoscopy  and  biopsy  if  a
    53  person  is  believed  to  be at increased risk for ovarian cancer due to
    54  family history or prior personal history  of  ovarian  cancer,  positive
    55  genetic  testing  or  other  indications  as determined by such person's
    56  physician or nurse practitioner.

        S. 5373                             3
 
     1    (B) Such additional coverage may be subject to annual deductibles  and
     2  coinsurance  as  may  be deemed appropriate by the superintendent and as
     3  are consistent with those established for other benefits within a  given
     4  policy.
     5    §  4.  This  act  shall take effect on the sixtieth day after it shall
     6  have become a law.
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