Amd §§3216, 3221 & 4303, Ins L; add §2404-e, Pub Health L
Ensures continuity of care for cancer patients during insurance contract negotiations by requiring insurance coverage and treatment continue until the conclusion of care.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A7944
SPONSOR: Sayegh TITLE OF BILL:
An act to amend the insurance law and the public health law, in relation
to ensuring continuity of care for cancer patients during insurance
contract negotiations
PURPOSE:
This legislation will ensure that for oncology patients currently being
treated for cancer, that both their insurers and oncology treatment.
providers will provide continuous care to these patients, even in the
event that the insurer and oncology treatment provider fail to agree
during contract renewal negotiations. In such an event, all such
patients will be "grandfathered" under the insurer and oncology treat-
ment provider, and will remain covered by insurance and treated by such
provider, for the balance of the course of their treatment.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 sets forth that this act shall be know and may be cited as the
"Continuity of Cancer Care Act" or the "COCCA".
Section 2 amends Section 3216 of the insurance law by adding language
stating insurers must continue covering care for such treatments,
regardless of contractual disputes, until the conclusion of the
insured's care.
Section 3 amends Section 3221 of the insurance law by adding language
stating insurers must continue covering care for such treatments,
regardless of contractual disputes, until the conclusion of the
insured's care.
Section 4 amends Section 4304 of the insurance law by adding language
stating insurers must continue covering care for such treatments,
regardless of contractual disputes, until the conclusion of the
insured's care.
Section 5 amends the Public Health Law by adding a new section 2404-e
entitled Cancer; duty to continue treatment - which states insurers must
continue covering care for such treatments, regardless of contractual
disputes, until the conclusion of the insured's care
Section 6 sets the effective date.
JUSTIFICATION:
Dealing with a diagnosis of cancer is difficult enough for both the
patient and their loved ones. For a patient to thereafter receive a
letter from their insurance provider, that their oncologists may no
longer be considered "in network" with such insurance provider, is
simply too much to bear. Nonetheless, in October 2024, a major insurer
provider sent such a letter to tens of thousands of its insured
patients, regarding their contract negotiations with Memorial Sloan
Kettering Cancer Center ("MSKCC"), stating coverage for any and all
treatments would end December 31, 2024. Soon thereafter, the insurance
provider sent a follow-up letter stating they would "grandfather" all
patients, currently under treatment, until March 31, 2025. Thankfully,
the parties came to an agreement. Had they not, thousands of cancer
patients would have been forced to leave MSKCC. This bill ensures that
any patients currently under treatment, will be automatically grandfa-
thered for continued care until the end of their treatment.
PRIOR LEGISLATIVE HISTORY:
NEW BILL
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
This act shall take effect on the ninetieth day after it shall have
become a law.
