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A06475 Summary:

BILL NOA06475
 
SAME ASNo Same As
 
SPONSORSeptimo
 
COSPNSR
 
MLTSPNSR
 
Amd §§3216, 3221 & 4303, Ins L
 
Requires health insurance policies to cover comprehensive genetic screening and FDA approved biomarker testing for ovarian and prostate cancers.
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A06475 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          6475
 
                               2025-2026 Regular Sessions
 
                   IN ASSEMBLY
 
                                      March 5, 2025
                                       ___________
 
        Introduced  by M. of A. SEPTIMO -- 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 and
          FDA approved biomarker testing for ovarian and prostate cancers

          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-a of subsection (i) of section 3216 of the insurance
     4  law is amended by adding a new subparagraph (C) to read as follows:
     5    (C) (i) Such policy shall provide additional full coverage for compre-
     6  hensive genetic testing and FDA approved  testing  based  on  family  or
     7  person's  history for prostatic and ovarian cancer when recommended by a
     8  doctor, a board-certified geneticist or a board-certified genetic  coun-
     9  selor.  Such coverage shall also be provided after the patient's initial
    10  diagnosis.  Patients  need  to know if they carry the genetic or inheri-
    11  tance mutation, which can help to determine possible treatments. Genetic
    12  screening shall be covered for prostate  and  ovarian  cancer  patients'
    13  family  members.  The  genetic  result  shall not be used against family
    14  members that carry the genetic or  inheritance  mutation  for  insurance
    15  coverage purposes.
    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    § 3. Paragraph 11-a of subsection (l) of section 3221 of the insurance
    20  law is amended by adding a new subparagraph (C) to read as follows:
    21    (C)(i) Such policy shall provide additional full coverage for  compre-
    22  hensive  genetic  testing  and  FDA  approved testing based on family or
    23  person's history for prostatic and ovarian cancer when recommended by  a
    24  doctor,  a board-certified geneticist or a board-certified genetic coun-
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD07098-01-5

        A. 6475                             2
 
     1  selor.  Such coverage shall also be provided after the patient's initial
     2  diagnosis. Patients need to know if they carry the  genetic  or  inheri-
     3  tance mutation, which can help to determine possible treatments. Genetic
     4  screening  shall  be  covered  for prostate and ovarian cancer patients'
     5  family members. The genetic result shall  not  be  used  against  family
     6  members  that  carry  the  genetic or inheritance mutation for insurance
     7  coverage purposes.
     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    §  4. Subsection (z-1) of section 4303 of the insurance law is amended
    12  by adding a new paragraph 3 to read as follows:
    13    (3)(A) Such policy shall provide additional full coverage for  compre-
    14  hensive  genetic  testing  and  FDA  approved testing based on family or
    15  person's history for prostatic and ovarian cancer when recommended by  a
    16  doctor,  a board-certified geneticist or a board-certified genetic coun-
    17  selor.
    18    (B) All costs associated with such additional full coverage shall  not
    19  be  subject  to  annual  deductibles  and coinsurance but shall be borne
    20  solely by the insurer.  Such coverage shall also be provided  after  the
    21  patient's  initial  diagnosis.  Patients  need to know if they carry the
    22  genetic or inheritance mutation, which can help  to  determine  possible
    23  treatments.  Genetic screening shall be covered for prostate and ovarian
    24  cancer patients' family members. The genetic result shall  not  be  used
    25  against  family  members  that carry the genetic or inheritance mutation
    26  for insurance coverage purposes.
    27    § 5. This act shall take effect on the sixtieth  day  after  it  shall
    28  have become a law and shall apply to all policies, contracts and certif-
    29  icates  issued,  renewed,  modified, altered or amended on or after such
    30  date.
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