STATE OF NEW YORK
________________________________________________________________________
3761
2013-2014 Regular Sessions
IN ASSEMBLY
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 § 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 § 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 § 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
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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 § 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 § 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 § 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 § 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 § 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.
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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 § 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 § 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.
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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 § 12. This act shall take effect on the sixtieth day after it shall
5 have become a law.
