NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A738
SPONSOR: Rozic (MS) TITLE OF BILL:
An act to amend the insurance law, in relation to requiring health
insurance policies to fully cover comprehensive genetic testing and FDA
approved biomarker testing for ovarian and prostate cancers
PURPOSE:
Requires health insurance policies to cover comprehensive genetic
screening for ovarian and prostate cancers
SUMMARY OF PROVISIONS:
Section I states that this act shall be cited as the "Ana Lucia Act."
Section II Paragraph 11-a of subsection (i) of section 3216 law is
amended by adding a new subparagraph (C)(i) to provide additional full
coverage for the comprehensive genetic testing and FDA approved testing
based on family or person's history when recommended by a board-certi-
fied geneticist or a board-certified genetic counselor.
Section IV Paragraph 11-a of subsection (1) of section 3221 of the
insurance law is amended by adding a new subparagraph (C) to provide
additional full coverage for the comprehensive genetic testing and FDA
approved testing based on family or person's history when recommended by
a board-certified geneticist or a board-certified genetic counselor.
Section IV Subsection (z-1) of section 4303 of the insurance law is
amended by adding a new paragraph 3(A) to provide additional full cover-
age for the comprehensive genetic testing and FDA approved testing based
on family or person's history when recommended by a board-certified
geneticist or a board-certified genetic counselor.
Section V provides for an effective date of the sixtieth day after it
shall become a law.
JUSTIFICATION:
This legislation mandates insurance companies cover the costs of genetic
testing and FDA-approved biomarker testing for ovarian and prostate
cancer, which could lead to early detection, and in some cases, prevents
some of the most common and life-threatening cancers: breast, prostate,
ovarian, colon, and lung cancers.. According to the American Cancer
Society, 1 in 41 men will die from prostate cancer, hence why it is "the
second leading cause of cancer death in American men, behind only lung
cancer." In 2021, there were approximately 248,530 new cases of prostate
cancer and roughly 34,130 deaths.
According to the National Center for Biotechnology Information, "ovarian
cancer is the ninth leading cause of cancer in women, but the fifth
leading cause of all cancer-related deaths." In 2009, there were 21,550
new cases, and 14,600 deaths were estimated. 1 in 78 American women will
be diagnosed with ovarian cancer during their lifetime.
Ovarian cancer is difficult to detect, particularly in the early stage;
its symptoms others such as bloating, pelvic or abdominal pain, trouble
eating or feeling full quickly, fatigue, upset stomach or heartburn,
back pain, pain during sex, constipation, menstrual changes, feeling the
need to urinate instantly or often. The ovaries are small, shaped like
almonds, located deep within the abdominal cavity; one on each side of
the uterus makes it hard to test for ovarian cancer. Currently, there is
no blood work to detect ovarian cancer.
Although we rely on the CA 125 to monitor women that are being treated
for ovarian cancer, it is not a helpful screening test for cancer. An
elevated CA 125 does not automatically mean one has cancer. A high level
of CA125 can occur due to many non-cancerous conditions. For instance,
roughly "3% of women with elevated CA 125 levels have ovarian cancer" Up
to 20% of ovarian cancer patients do not have an elevated CA 125 (Medi-
cineNet).
LEGISLATIVE HISTORY:
2022: A425A (Rozic) - Insurance
2021: A425A (Rozic) - Insurance 2020: Referred to Insurance
FISCAL IMPACT ON THE STATE:
To be determined.
EFFECTIVE DATE:
This act shall take effect on the sixtieth day after it shall have
become law.
STATE OF NEW YORK
________________________________________________________________________
738
2023-2024 Regular Sessions
IN ASSEMBLY
January 11, 2023
___________
Introduced by M. of A. ROZIC, AUBRY, BRONSON, COLTON, COOK, OTIS, SIMON,
WEPRIN -- Multi-Sponsored by -- M. of A. GUNTHER, RIVERA -- read once
and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring health
insurance policies to fully cover comprehensive genetic testing and
FDA approved biomarker testing for ovarian and prostate cancers
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. This act shall be known and may be cited as the "Ana Lucia
2 act".
3 § 2. Paragraph 11-a of subsection (i) of section 3216 of the insurance
4 law is amended by adding a new subparagraph (C) to read as follows:
5 (C) (i) Such policy shall provide additional full coverage for compre-
6 hensive genetic testing and FDA approved testing based on family or
7 person's history for prostatic and ovarian cancer when recommended by a
8 doctor, a board-certified geneticist or a board-certified genetic coun-
9 selor. Such coverage shall also be provided after the patient's initial
10 diagnosis. Patients need to know if they carry the genetic or inheri-
11 tance mutation, which can help to determine possible treatments. Genetic
12 screening shall be covered for prostate and ovarian cancer patients'
13 family members. The genetic result shall not be used against family
14 members that carry the genetic or inheritance mutation for insurance
15 coverage purposes.
16 (ii) All costs associated with such additional full coverage shall not
17 be subject to annual deductibles and coinsurance but shall be borne
18 solely by the insurer.
19 § 3. Paragraph 11-a of subsection (l) of section 3221 of the insurance
20 law is amended by adding a new subparagraph (C) to read as follows:
21 (C)(i) Such policy shall provide additional full coverage for compre-
22 hensive genetic testing and FDA approved testing based on family or
23 person's history for prostatic and ovarian cancer when recommended by a
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD00460-01-3
A. 738 2
1 doctor, a board-certified geneticist or a board-certified genetic coun-
2 selor. Such coverage shall also be provided after the patient's initial
3 diagnosis. Patients need to know if they carry the genetic or inheri-
4 tance mutation, which can help to determine possible treatments. Genetic
5 screening shall be covered for prostate and ovarian cancer patients'
6 family members. The genetic result shall not be used against family
7 members that carry the genetic or inheritance mutation for insurance
8 coverage purposes.
9 (ii) All costs associated with such additional full coverage shall not
10 be subject to annual deductibles and coinsurance but shall be borne
11 solely by the insurer.
12 § 4. Subsection (z-1) of section 4303 of the insurance law is amended
13 by adding a new paragraph 3 to read as follows:
14 (3)(A) Such policy shall provide additional full coverage for compre-
15 hensive genetic testing and FDA approved testing based on family or
16 person's history for prostatic and ovarian cancer when recommended by a
17 doctor, a board-certified geneticist or a board-certified genetic coun-
18 selor.
19 (B) All costs associated with such additional full coverage shall not
20 be subject to annual deductibles and coinsurance but shall be borne
21 solely by the insurer. Such coverage shall also be provided after the
22 patient's initial diagnosis. Patients need to know if they carry the
23 genetic or inheritance mutation, which can help to determine possible
24 treatments. Genetic screening shall be covered for prostate and ovarian
25 cancer patients' family members. The genetic result shall not be used
26 against family members that carry the genetic or inheritance mutation
27 for insurance coverage purposes.
28 § 5. This act shall take effect on the sixtieth day after it shall
29 have become a law and shall apply to all policies, contracts and certif-
30 icates issued, renewed, modified, altered or amended on or after such
31 date.
