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.
STATE OF NEW YORK
________________________________________________________________________
1439
2025-2026 Regular Sessions
IN ASSEMBLY
January 9, 2025
___________
Introduced by M. of A. HUNTER, RAGA -- 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-d to read as follows:
3 (11-d) (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-d to read as follows:
12 (11-d) (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-2) to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD01785-01-5
A. 1439 2
1 (p-2) (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 (nn) to read as follows:
12 (nn) 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.
