A02325 Summary:

BILL NO    A02325 

SAME AS    No same as 

SPONSOR    Pretlow

COSPNSR    

MLTSPNSR   Pheffer

Amd SS3216, 3221 & 4303, Ins L

Requires accident and health insurance policies to cover the cost of genetic
testing of persons with a family history of cancer when the attending physician
determines such person has a significant risk thereof.
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A02325 Actions:

BILL NO    A02325 

01/18/2011 referred to insurance
01/04/2012 referred to insurance
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A02325 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          2325
 
                               2011-2012 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 18, 2011
                                       ___________
 
        Introduced  by M. of A. PRETLOW -- read once and referred to the Commit-
          tee on Insurance
 
        AN ACT to amend the insurance law, in relation to requiring coverage for
          genetic testing in accident and health insurance policies
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 

     1    Section  1.  Section  3216 of the insurance law is amended by adding a
     2  new subsection (m) to read as follows:
     3    (m) (1) (A) For purposes of  this  subsection:  "Predisposing  genetic
     4  characteristic"  shall  mean any inherited gene or chromosome, or alter-
     5  ation thereof, and determined by a genetic test or inferred from  infor-
     6  mation  derived  from  an  individual or family member that is scientif-
     7  ically  or  medically  believed  to  predispose  an  individual  or  the
     8  offspring  of that individual to a disease or disability, or to be asso-
     9  ciated with a statistically significant increased risk of  the  develop-
    10  ment of a physical or mental disease or disability; and
    11    (B)  "Genetic  testing" shall mean a test for determining the presence

    12  or absence of an inherited  genetic  characteristic  in  an  individual,
    13  including tests of nucleic acids such as DNA, RNA and mitochondrial DNA,
    14  chromosomes  or  proteins  in  order  to identify a predisposing genetic
    15  characteristic.
    16    (2) On and after September first, two  thousand  eleven  every  policy
    17  delivered  or  issued  for delivery in this state which provides medical
    18  coverage that includes coverage for physician services in a  physician's
    19  office  and every policy which provides major medical or similar compre-
    20  hensive-type coverage shall provide coverage for  genetic  testing,  and
    21  any  subsequent  treatment  resulting  from the results of such test, of
    22  persons who, in the opinion of an attending physician are persons with a

    23  significant risk of contracting cancer. For purposes of this section,  a
    24  person  shall  be deemed to have a significant risk if there is a family
    25  history of cancer, more than one  generation  in  such  family  has  had
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02459-01-1

        A. 2325                             2
 
     1  cancer,  a family member has had more than one occurrence of cancer or a
     2  family member less than forty-five years of age has been diagnosed  with
     3  cancer.  Nothing  in  this  subsection  shall  be deemed to authorize an

     4  insurer  to  utilize  or  release the results of such test for any other
     5  purpose. No policy delivered or issued for delivery in this state pursu-
     6  ant to this article, shall be denied or cancelled  on  the  basis  of  a
     7  predisposing genetic characteristic.
     8    § 2. Subsection (l) of section 3221 of the insurance law is amended by
     9  adding a new paragraph 11-b to read as follows:
    10    (11-b)  (A)  (i) For purposes of this paragraph: "Predisposing genetic
    11  characteristic" shall mean any inherited gene or chromosome,  or  alter-
    12  ation  thereof, and determined by a genetic test or inferred from infor-
    13  mation derived from an individual or family  member  that  is  scientif-
    14  ically  or  medically  believed  to  predispose  an  individual  or  the

    15  offspring of that individual to a disease or disability, or to be  asso-
    16  ciated  with  a statistically significant increased risk of the develop-
    17  ment of a physical or mental disease or disability; and
    18    (ii) "Genetic testing" shall mean a test for determining the  presence
    19  or  absence  of  an  inherited  genetic characteristic in an individual,
    20  including tests of nucleic acids such as DNA, RNA and mitochondrial DNA,
    21  chromosomes or proteins in order  to  identify  a  predisposing  genetic
    22  characteristic.
    23    (B)  On  and  after  September first, two thousand eleven every policy
    24  delivered or issued for delivery in this state  which  provides  medical
    25  coverage  that includes coverage for physician services in a physician's

    26  office and major medical or similar  comprehensive-type  coverage  shall
    27  provide  coverage  for  genetic  testing,  and  any subsequent treatment
    28  resulting from the results of such test, of persons who, in the  opinion
    29  of  an  attending  physician  are  persons  with  a  significant risk of
    30  contracting cancer. For purposes of this  section,  a  person  shall  be
    31  deemed  to  have  a  significant  risk  if  there is a family history of
    32  cancer, more than one generation in such family has had cancer, a family
    33  member has had more than one occurrence of cancer  or  a  family  member
    34  less  than forty-five years of age has been diagnosed with cancer. Noth-
    35  ing in this paragraph shall be deemed to authorize an insurer to utilize

    36  or release the results of such test for any  other  purpose.  No  policy
    37  delivered or issued for delivery in this state pursuant to this article,
    38  shall  be  denied  or  cancelled  on the basis of a predisposing genetic
    39  characteristic.
    40    § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
    41  subsection (hh) to read as follows:
    42    (hh)  (1)  (A)  For purposes of this subsection: "Predisposing genetic
    43  characteristic" shall mean any inherited gene or chromosome,  or  alter-
    44  ation  thereof, and determined by a genetic test or inferred from infor-
    45  mation derived from an individual or family  member  that  is  scientif-
    46  ically  or  medically  believed  to  predispose  an  individual  or  the

    47  offspring of that individual to a disease or disability, or to be  asso-
    48  ciated  with  a statistically significant increased risk of the develop-
    49  ment of a physical or mental disease or disability; and
    50    (B) "Genetic testing" shall mean a test for determining  the  presence
    51  or  absence  of  an  inherited  genetic characteristic in an individual,
    52  including tests of nucleic acids such as DNA, RNA and mitochondrial DNA,
    53  chromosomes or proteins in order  to  identify  a  predisposing  genetic
    54  characteristic.
    55    (2)  On  and  after  September first, two thousand eleven every policy
    56  delivered or issued for delivery in this state  which  provides  medical

        A. 2325                             3
 

     1  coverage  that includes coverage for physician services in a physician's
     2  office or major medical or  similar  comprehensive-type  coverage  shall
     3  provide  coverage  for  genetic  testing,  and  any subsequent treatment
     4  resulting  from the results of such test, of persons who, in the opinion
     5  of an attending  physician  are  persons  with  a  significant  risk  of
     6  contracting  cancer.  For  purposes  of  this section, a person shall be
     7  deemed to have a significant risk  if  there  is  a  family  history  of
     8  cancer, more than one generation in such family has had cancer, a family
     9  member  has  had  more  than one occurrence of cancer or a family member
    10  less than forty-five years of age has been diagnosed with cancer.  Noth-

    11  ing  in  this  subsection  shall  be  deemed  to authorize an insurer to
    12  utilize or release the results of such test for any  other  purpose.  No
    13  policy  delivered  or issued for delivery in this state pursuant to this
    14  article, shall be denied or cancelled on the  basis  of  a  predisposing
    15  genetic characteristic.
    16    § 4. This act shall take effect immediately.
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