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.
