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A01641 Summary:

BILL NOA01641
 
SAME ASSAME AS S01187
 
SPONSORHunter
 
COSPNSRRaga
 
MLTSPNSR
 
Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L; add §2405-a, Pub Health L
 
Requires health insurance policies to offer full coverage for annual testing for ovarian cancer; requires certain health care providers offer annual testing for ovarian cancer.
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A01641 Actions:

BILL NOA01641
 
01/17/2023referred to insurance
01/03/2024referred to insurance
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A01641 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A1641
 
SPONSOR: Hunter
  TITLE OF BILL: An act to amend the insurance law, the social services law and the public health law, in relation to requiring health insurance policies to fully cover testing for ovarian cancer and requiring certain health care providers to offer annual testing for ovarian cancer   PURPOSE OR GENERAL IDEA OF BILL: Requires health insurance policies to fully cover testing for ovarian cancer and requires certain health care providers to offer annual test- ing for ovarian cancer   SUMMARY OF SPECIFIC PROVISIONS: Section 1. Every policy that provides coverage for hospital, surgical or medical care shall offer full coverage for annual testing to patients that are at high-risk of developing ovarian cancer including, but not limited to, FDA-approved testing, transvaginal ultrasound, pelvic exam, and other exams regardless if presenting signs and symptoms Section 2. Applies the same provisions to every insurer delivering a group or blan- ket policy or issuing a group or blanket policy for delivery in this state that provides coverage for hospital, surgical or medical care. Section 3. Applies these same provisions to a medical expense indemnity corporation, a hospital service corporation, or a health service corpo- ration that provides coverage for hospital, surgical, or medical care. Section 4. Annual ovarian cancer testing including, but not limited to, FDA-approved testing, pelvic exam, transvaginal ultrasound and other exams to be made readily available to those at risk or high-risk for cancer regardless if presenting signs and symptoms. Section 5. Required offering of ovarian cancer testing. Ovarian cancer literacy pamphlet to be provided to a patient. Section 6. Provides for the effective date.   JUSTIFICATION: Typically, the general CA125 misses more than half of all cancer cases once a mass is found and primarily detects only when it is late-stage, in most cases too late. The CA125 misses between 37-67% of ovarian cancer cases in Black women. Black women have a much higher 5-year ovarian cancer mortality rate of 62 percent. As with other cancers, it is best to diagnose the disease in its early stages to best treat the cancer and defeat the disease. Ovarian Cancer is more likely to be missed or miss-diagnosed due to symptoms that overlap with more benign conditions such as endometriosis or due to diagnostic tests that were not created for this cause being used.. Allowing and mandating screening for ovarian cancer yearly is necessary to curtail the number of deaths that occur each year from ovarian cancer. Ovarian cancer is a disease that mostly affects older women, especially after menopause. As of 2022, an annual gynecological exam does not test for ovarian cancer but covers cervical and other cancer. The American Cancer Society states that in 2022, about 20,000 women will receive a new diagnosis of ovarian cancer and about 13,000 women will die from ovarian cancer. The ACA finds that if a woman has a family member who has been diagnosed with ovarian cancer, they are now 25 percent more likely to get the disease; as the likelihood of having ovarian cancer increases because of certain genes in one's DNA that is passed on to offspring. Screening tests and educating patients about ovarian cancer will serve as great preventive measures to reduce ovarian cancer-related deaths. In addition to the screening tests, educating patients through pamphlets about ovarian cancer is another great preventative measure. The more educated the patient is, the more likely they are to notice if something is wrong or has changed in their body, and it will prompt them to visit their medical provider. This also helps patients who previously had cancer or are more prone to getting it.   PRIOR LEGISLATIVE HISTORY: 2021-22: A9228   FISCAL IMPLICATIONS: None   EFFECTIVE DATE: The act shall take effect on the thirtieth day after it shall become law.
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A01641 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          1641
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 17, 2023
                                       ___________
 
        Introduced by M. of A. HUNTER -- read once and referred to the Committee
          on Insurance
 
        AN  ACT  to  amend  the  insurance  law, the social services law and the
          public health law, in relation to requiring health insurance  policies
          to fully cover testing for ovarian cancer and requiring certain health
          care providers to offer annual testing for ovarian cancer
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
     2  amended by adding a new paragraph 11-c to read as follows:
     3    (11-c)  (A) Every policy that provides coverage for hospital, surgical
     4  or medical care shall offer full coverage for annual testing to patients
     5  that are at high-risk of developing ovarian cancer  including,  but  not
     6  limited  to, FDA-approved testing, transvaginal ultrasound, pelvic exam,
     7  and other exams regardless if presenting signs and symptoms.
     8    (B) Such additional coverage shall not be subject  to  annual  deduct-
     9  ibles and coinsurance but shall be borne solely by the insurer.
    10    § 2. Subsection (l) of section 3221 of the insurance law is amended by
    11  adding a new paragraph 11-c to read as follows:
    12    (11-c) (A) Every insurer delivering a group or blanket policy or issu-
    13  ing  a  group or blanket policy for delivery in this state that provides
    14  coverage for hospital, surgical or medical care shall offer full  cover-
    15  age for annual testing for individuals at high-risk of developing ovari-
    16  an  cancer including, but not limited to, FDA-approved testing, transva-
    17  ginal ultrasound, pelvic exam  and  other exams available  to  those  at
    18  high-risk  of  developing  ovarian cancer regardless if presenting signs
    19  and symptoms.
    20    (B) Such additional coverage shall not be subject  to  annual  deduct-
    21  ibles and coinsurance but shall be borne solely by the insurer.
    22    §  3.  Section  4303  of  the insurance law is amended by adding a new
    23  subsection (p-1) to read as follows:
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02610-01-3

        A. 1641                             2
 
     1    (p-1) (1) A medical expense indemnity corporation, a hospital  service
     2  corporation  or  a health service corporation that provides coverage for
     3  hospital, surgical or medical care shall offer full coverage for  annual
     4  testing  for  individuals  at  high-risk  of  developing  ovarian cancer
     5  including, but not limited to, FDA-approved testing, transvaginal ultra-
     6  sound,  pelvic  exam  and  other  exams  for individuals at high-risk of
     7  developing ovarian cancer regardless if presenting signs or symptoms.
     8    (2) Such additional coverage shall not be subject  to  annual  deduct-
     9  ibles and coinsurance but shall be borne solely by the insurer.
    10    §  4.  Subdivision  2  of  section 365-a of the social services law is
    11  amended by adding a new paragraph (iii) to read as follows:
    12    (iii) annual ovarian cancer testing including,  but  not  limited  to,
    13  FDA-approved  testing,  pelvic  exam, transvaginal ultrasound and  other
    14  exams available to those at risk or high-risk for cancer  regardless  if
    15  presenting signs and symptoms.
    16    §  5.  The public health law is amended by adding a new section 2405-a
    17  to read as follows:
    18    § 2405-a. Required offering of ovarian cancer testing.  1. Health care
    19  providers such as a physician, physician assistant, nurse  practitioner,
    20  or midwife providing primary care shall ask specific questions to deter-
    21  mine  if  there  are  any  signs  or  symptoms that may indicate ovarian
    22  cancer. Once signs and symptoms of ovarian cancer have been detected, or
    23  a provider is suspicious the patient has ovarian cancer, ovarian  cancer
    24  "testing"  may  then  be performed, which could encompass a pelvic exam,
    25  FDA-approved testing,  transvaginal  ultrasound,  and  other  exams  for
    26  ovarian cancer. Additionally, providers shall avail patients with ovari-
    27  an  cancer  education, including, but not limited to, information on the
    28  signs and symptoms of ovarian cancer and providing the  patient  with  a
    29  copy of the informational pamphlet developed and supplied by the depart-
    30  ment,  unless  the  health  care  practitioner  providing  such services
    31  reasonably believes that: (a) the individual is being treated for a life
    32  threatening emergency; or (b) the individual lacks capacity  to  consent
    33  to ovarian cancer testing.
    34    2. As used in this section, "primary care" means the medical fields of
    35  family  medicine,  general  pediatrics, primary care, internal medicine,
    36  primary care obstetrics, or primary care gynecology, without  regard  to
    37  board certification.
    38    3.  The offering of ovarian cancer testing under this section shall be
    39  culturally and linguistically appropriate in accordance with  rules  and
    40  regulations promulgated by the commissioner.
    41    4.  The  department  shall  develop informational pamphlets on ovarian
    42  cancer and supply such pamphlets to health service providers.
    43    5. This section shall not affect the scope of practice of  any  health
    44  care  practitioner  or  diminish  any authority or legal or professional
    45  obligation of any health care practitioner to offer ovarian cancer test-
    46  ing or to provide services or care for the  subject  of  ovarian  cancer
    47  testing.
    48    §  6. This act shall take effect on the first of January next succeed-
    49  ing the date on which it shall have become a  law  and  shall  apply  to
    50  policies issued, reissued, renewed, modified or amended on or after such
    51  date.
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