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A03761 Summary:

BILL NO    A03761 

SAME AS    No same as 

SPONSOR    Espinal

COSPNSR    Stevenson, Lavine, Titone, Jaffee, Miller, Cook, Graf, O'Donnell,
           Aubry, Skoufis, Rozic, Millman, Abinanti, Colton, Sepulveda, Borelli,
           Scarborough

MLTSPNSR   Arroyo, Brennan, Ceretto, Clark, Gunther, Kearns, McLaughlin, Perry,
           Rivera, Simanowitz, Weisenberg

Amd SS3216, 3221, 4303 & 4326, Ins L

Requires health insurance policies to cover comprehensive genetic screening for
breast, ovarian, prostate, colon and lung cancers.
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A03761 Actions:

BILL NO    A03761 

01/29/2013 referred to insurance
11/20/2013 enacting clause stricken
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A03761 Text:

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

                                         3761

                              2013-2014 Regular Sessions

                                 I N  A S S E M B L Y

                                   January 29, 2013
                                      ___________

       Introduced  by M. of A. ESPINAL -- read once and referred to the Commit-
         tee on Insurance

       AN ACT to amend the insurance  law,  in  relation  to  requiring  health
         insurance  policies  to  fully cover comprehensive genetic testing for
         breast, ovarian, prostate, colon and lung cancers in certain cases

         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    S 2. Paragraph 11 of subsection (i) of section 3216 of  the  insurance
    4  law is amended by adding a new subparagraph (F) to read as follows:
    5    (F) (I) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
    6  HENSIVE  GENETIC  TESTING  FOR  BREAST  CANCER  ONLY IF RECOMMENDED BY A
    7  BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
    8    (II) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
    9  BE SUBJECT TO ANNUAL DEDUCTIBLES AND  COINSURANCE  BUT  SHALL  BE  BORNE
   10  SOLELY BY THE INSURER.
   11    S 3. Paragraph 11-a of subsection (i) of section 3216 of the insurance
   12  law is amended by adding a new subparagraph (C) to read as follows:
   13    (C) (I) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
   14  HENSIVE  GENETIC  TESTING  FOR PROSTATIC CANCER ONLY IF RECOMMENDED BY A
   15  BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
   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    S  4.  Paragraph 11 of subsection (l) of section 3221 of the insurance
   20  law is amended by adding a new subparagraph (F) to read as follows:
   21    (F) (I) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
   22  HENSIVE GENETIC TESTING FOR BREAST  CANCER  ONLY  IF  RECOMMENDED  BY  A
   23  BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.

        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD06910-01-3
       A. 3761                             2

    1    (II) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
    2  BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND COINSURANCE BUT SHALL BE BORNE
    3  SOLELY BY THE INSURER.
    4    S 5. Paragraph 11-a of subsection (l) of section 3221 of the insurance
    5  law is amended by adding a new subparagraph (C) to read as follows:
    6    (C)(I)  SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
    7  HENSIVE GENETIC TESTING FOR PROSTATIC CANCER ONLY IF  RECOMMENDED  BY  A
    8  BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
    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    S 6. Subsection (p) of section 4303 of the insurance law is amended by
   13  adding a new paragraph 5 to read as follows:
   14    (5) (I) SUCH COVERAGE  SHALL  PROVIDE  ADDITIONAL  FULL  COVERAGE  FOR
   15  COMPREHENSIVE GENETIC TESTING FOR BREAST CANCER ONLY IF RECOMMENDED BY A
   16  BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
   17    (II) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
   18  BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND COINSURANCE BUT SHALL BE BORNE
   19  SOLELY BY THE INSURER.
   20    S 7. Subsection (z-1) of section 4303 of the insurance law is  amended
   21  by adding a new paragraph 3 to read as follows:
   22    (3)(A)  SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
   23  HENSIVE GENETIC TESTING FOR PROSTATIC CANCER ONLY IF  RECOMMENDED  BY  A
   24  BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
   25    (B)  ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
   26  BE SUBJECT TO ANNUAL DEDUCTIBLES AND  COINSURANCE  BUT  SHALL  BE  BORNE
   27  SOLELY BY THE INSURER.
   28    S  8.  Paragraph  7 of subsection (d) of section 4326 of the insurance
   29  law, as added by chapter 1 of the laws of 1999, is amended  to  read  as
   30  follows:
   31    (7) adult preventive health services consisting of mammography screen-
   32  ing AND GENETIC SCREENING, AS PROVIDED IN SUBSECTION (P) OF SECTION FOUR
   33  THOUSAND  THREE  HUNDRED  THREE  OF THIS ARTICLE; OVARIAN CANCER GENETIC
   34  SCREENING AS PROVIDED IN SUBSECTION (P-1) OF SECTION FOUR THOUSAND THREE
   35  HUNDRED THREE OF THIS ARTICLE; cervical cytology screening; COLON CANCER
   36  GENETIC SCREENING AS PROVIDED IN SUBSECTION (P-2) OF SECTION FOUR  THOU-
   37  SAND  THREE HUNDRED THREE OF THIS ARTICLE; LUNG CANCER GENETIC SCREENING
   38  AS PROVIDED IN SUBSECTION (P-3) OF SECTION FOUR THOUSAND  THREE  HUNDRED
   39  THREE  OF THIS ARTICLE; PROSTATE CANCER GENETIC SCREENING AS PROVIDED IN
   40  SUBSECTION (Z-1) OF SECTION FOUR THOUSAND THREE HUNDRED  THREE  OF  THIS
   41  ARTICLE;  periodic  physical  examinations no more than once every three
   42  years; and adult immunizations;
   43    S 9. Subsection (i) of section 3216 of the insurance law is amended by
   44  adding three new paragraphs 11-b, 11-c and 11-d to read as follows:
   45    (11-B) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL,  SURGICAL
   46  OR  MEDICAL  CARE  SHALL PROVIDE FULL COVERAGE FOR GENETIC SCREENING FOR
   47  OVARIAN CANCER ONLY IF RECOMMENDED BY A BOARD-CERTIFIED GENETICIST OR  A
   48  BOARD-CERTIFIED GENETIC COUNSELOR.
   49    (B)  SUCH  ADDITIONAL  COVERAGE SHALL NOT BE SUBJECT TO ANNUAL DEDUCT-
   50  IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
   51    (11-C) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL,  SURGICAL
   52  OR  MEDICAL  CARE  SHALL PROVIDE FULL COVERAGE FOR GENETIC SCREENING FOR
   53  COLON CANCER ONLY IF RECOMMENDED BY A BOARD-CERTIFIED  GENETICIST  OR  A
   54  BOARD-CERTIFIED GENETIC COUNSELOR.
       A. 3761                             3

    1    (B)  ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
    2  BE SUBJECT TO ANNUAL DEDUCTIBLES AND  COINSURANCE  BUT  SHALL  BE  BORNE
    3  SOLELY BY THE INSURER.
    4    (11-D)  (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL
    5  OR MEDICAL CARE SHALL PROVIDE FULL COVERAGE FOR  GENETIC  SCREENING  FOR
    6  LUNG  CANCER  ONLY  IF  RECOMMENDED BY A BOARD-CERTIFIED GENETICIST OR A
    7  BOARD-CERTIFIED GENETIC COUNSELOR.
    8    (B) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL  NOT
    9  BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND COINSURANCE BUT SHALL BE BORNE
   10  SOLELY BY THE INSURER.
   11    S 10. Subsection (l) of section 3221 of the insurance law  is  amended
   12  by adding three new paragraphs 11-b, 11-c and 11-d to read as follows:
   13    (11-B) (A) EVERY INSURER DELIVERING A GROUP OR BLANKET POLICY OR ISSU-
   14  ING  A  GROUP OR BLANKET POLICY FOR DELIVERY IN THIS STATE THAT PROVIDES
   15  COVERAGE FOR HOSPITAL, SURGICAL  OR  MEDICAL  CARE  SHALL  PROVIDE  FULL
   16  COVERAGE  OR GENETIC SCREENING FOR OVARIAN CANCER ONLY IF RECOMMENDED BY
   17  A BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
   18    (B) SUCH ADDITIONAL COVERAGE SHALL NOT BE SUBJECT  TO  ANNUAL  DEDUCT-
   19  IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
   20    (11-C)  (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL
   21  OR MEDICAL CARE SHALL PROVIDE FULL COVERAGE FOR  GENETIC  SCREENING  FOR
   22  COLON  CANCER  ONLY  IF RECOMMENDED BY A BOARD-CERTIFIED GENETICIST OR A
   23  BOARD-CERTIFIED GENETIC COUNSELOR.
   24    (B) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL  NOT
   25  BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND COINSURANCE BUT SHALL BE BORNE
   26  SOLELY BY THE INSURER.
   27    (11-D) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL,  SURGICAL
   28  OR  MEDICAL  CARE  SHALL PROVIDE FULL COVERAGE FOR GENETIC SCREENING FOR
   29  LUNG CANCER ONLY IF RECOMMENDED BY A  BOARD-CERTIFIED  GENETICIST  OR  A
   30  BOARD-CERTIFIED GENETIC COUNSELOR.
   31    (B)  ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
   32  BE SUBJECT TO ANNUAL DEDUCTIBLES AND  COINSURANCE  BUT  SHALL  BE  BORNE
   33  SOLELY BY THE INSURER.
   34    S 11. Section 4303 of the insurance law is amended by adding three new
   35  subsections (p-1), (p-2) and (p-3) to read as follows:
   36    (P-1)  (1) A MEDICAL EXPENSE INDEMNITY CORPORATION, A HOSPITAL SERVICE
   37  CORPORATION OR A HEALTH SERVICE CORPORATION THAT PROVIDES  COVERAGE  FOR
   38  HOSPITAL,  SURGICAL  OR  MEDICAL  CARE  SHALL  PROVIDE FULL COVERAGE FOR
   39  GENETIC SCREENING FOR OVARIAN CANCER ONLY IF RECOMMENDED BY A BOARD-CER-
   40  TIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
   41    (2) SUCH ADDITIONAL COVERAGE SHALL NOT BE SUBJECT  TO  ANNUAL  DEDUCT-
   42  IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
   43    (P-2)  (1) A MEDICAL EXPENSE INDEMNITY CORPORATION, A HOSPITAL SERVICE
   44  CORPORATION OR A HEALTH SERVICE CORPORATION THAT PROVIDES  COVERAGE  FOR
   45  HOSPITAL,  SURGICAL  OR  MEDICAL  CARE  SHALL  PROVIDE FULL COVERAGE FOR
   46  GENETIC SCREENING FOR COLON CANCER ONLY IF RECOMMENDED BY A BOARD-CERTI-
   47  FIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
   48    (2) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL  NOT
   49  BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND COINSURANCE BUT SHALL BE BORNE
   50  SOLELY BY THE INSURER.
   51    (P-3) (1) A MEDICAL EXPENSE INDEMNITY CORPORATION, A HOSPITAL  SERVICE
   52  CORPORATION  OR  A HEALTH SERVICE CORPORATION THAT PROVIDES COVERAGE FOR
   53  HOSPITAL, SURGICAL OR MEDICAL  CARE  SHALL  PROVIDE  FULL  COVERAGE  FOR
   54  GENETIC  SCREENING FOR LUNG CANCER ONLY IF RECOMMENDED BY A BOARD-CERTI-
   55  FIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
       A. 3761                             4

    1    (2) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL  NOT
    2  BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND COINSURANCE BUT SHALL BE BORNE
    3  SOLELY BY THE INSURER.
    4    S  12.  This  act shall take effect on the sixtieth day after it shall
    5  have become a law.
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