A02464 Summary:

BILL NO    A02464 

SAME AS    No same as 

SPONSOR    Pretlow

COSPNSR    

MLTSPNSR   

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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A02464 Actions:

BILL NO    A02464 

01/16/2009 referred to insurance
01/06/2010 referred to insurance
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A02464 Text:

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

                                         2464

                              2009-2010 Regular Sessions

                                 I N  A S S E M B L Y

                                   January 16, 2009
                                      ___________

       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  NINE  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.
                                                                  LBD00939-01-9
       A. 2464                             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    S 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 NINE 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    S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
   41  subsection (ff) to read as follows:
   42    (FF)  (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 NINE EVERY POLICY
   56  DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE  WHICH  PROVIDES  MEDICAL
       A. 2464                             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    S 4. This act shall take effect immediately.
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