New York State Assembly

 
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A01195 Summary:

A01195 Actions:

A01195 Committee Votes:

Committee:INSURANCE   Chair:Weprin      
DATE:05/20/2025AYE/NAY:25/0  Action: Favorable refer to committee Rules        
Weprin
Aye
Blankenbush
Aye
Cook
Aye
Hawley
Aye
Lavine
Aye
Palmesano
Aye
Steck
Aye
Gandolfo
Aye
Dilan
Aye
Jensen
Aye
Hunter
Aye
Blumencranz
Aye
Jacobson
Aye
Bendett
Aye
Meeks
Aye
Forrest
Aye
Anderson
Aye
Cruz
Aye
Bores
Aye
Lunsford
Aye
Berger
Aye
Eichenstein
Aye
Kay
Aye
Yeger
Aye
Wieder
Aye

Committee:RULES   Chair:Glick      
DATE:05/21/2025AYE/NAY:29/0  Action: Favorable         
Heastie
Excused
Barclay
Aye
Pretlow
Aye
Hawley
Aye
Cook
Aye
Blankenbush
Aye
Glick
Aye
Ra
Aye
Dinowitz
Aye
Brabenec
Aye
Colton
Aye
Palmesano
Aye
Magnarelli
Aye
Reilly
Aye
Paulin
Excused
Smith
Aye
Peoples-Stokes
Aye
Jensen
Aye
Benedetto
Aye
Lavine
Aye
Lupardo
Aye
Braunstein
Aye
Davila
Aye
Hyndman
Aye
Rozic
Aye
Bronson
Aye
Hevesi
Aye
Hunter
Aye
Taylor
Aye
Cruz
Aye
Vanel
Aye

A01195 Floor Votes:

A01195 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         1195--A
 
                               2025-2026 Regular Sessions
 
                   IN ASSEMBLY
 
                                     January 9, 2025
                                       ___________
 
        Introduced  by  M.  of A. PEOPLES-STOKES, WEPRIN, REYES, SHIMSKY, SIMON,
          HEVESI, LUNSFORD, CRUZ,  MEEKS,  STECK,  RAGA,  LUPARDO,  BUTTENSCHON,
          O'PHARROW, SIMONE, BURDICK, ZACCARO, LAVINE, BRONSON, EPSTEIN, STIRPE,
          SANTABARBARA, MAHER, SLATER -- read once and referred to the Committee
          on  Insurance -- committee discharged, bill amended, ordered reprinted
          as amended and recommitted to said committee
 
        AN ACT to amend the insurance  law,  in  relation  to  mandatory  health
          insurance  coverage for follow-up screening or diagnostic services for
          lung 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 41 to read as follows:
     3    (41) (A) Every policy which provides medical, major medical, or  simi-
     4  lar  comprehensive-type  coverage  shall  provide coverage for follow-up
     5  screening or diagnostic services for lung cancer upon the recommendation
     6  of a health care provider acting within the provider's scope of practice
     7  pursuant to title eight of the education  law,  and  as  recommended  by
     8  nationally  recognized clinical practice guidelines for the detection of
     9  lung cancer.
    10    (B) Notwithstanding any  other  provision  of  law,  any  policy  that
    11  provides  coverage  required  by this paragraph shall not impose patient
    12  cost sharing for follow-up screening or  diagnostic  services  for  lung
    13  cancer.
    14    (C)  For  the purposes of this paragraph, "nationally recognized clin-
    15  ical practice guidelines" means evidence-based, peer  reviewed  clinical
    16  practice  guidelines  informed by a systematic review of evidence and an
    17  assessment of the  benefits,  and  risks  of  alternative  care  options
    18  intended to optimize patient care developed by independent organizations
    19  or  medical  professional  societies utilizing a transparent methodology
    20  and reporting structure and with a conflict of interest policy.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD02876-02-5
        A. 1195--A                          2
 
     1    (D) Nothing in this paragraph shall be construed  to  prevent  medical
     2  management  or utilization review of the services, including preauthori-
     3  zation, to ensure that such  services  are  consistent  with  nationally
     4  recognized  clinical  practice  guidelines  for  the  detection  of lung
     5  cancer.
     6    (E)  If  the  policy  is  a  high deductible health plan as defined in
     7  section 223(c)(2) of the Internal Revenue Code of  1986,  such  coverage
     8  may  be  subject  to the plan's annual deductible if application of this
     9  requirement would result in ineligibility for a health savings account.
    10    § 2. Subsection (l) of section 3221 of the insurance law is amended by
    11  adding a new paragraph 23 to read as follows:
    12    (23) (A) Every policy which provides medical, major medical, or  simi-
    13  lar  comprehensive-type  coverage  shall  provide coverage for follow-up
    14  screening or diagnostic services for lung cancer upon the recommendation
    15  of a health care provider acting within the provider's scope of practice
    16  pursuant to title eight of the education  law,  and  as  recommended  by
    17  nationally  recognized clinical practice guidelines for the detection of
    18  lung cancer.
    19    (B) Notwithstanding any  other  provision  of  law,  any  policy  that
    20  provides  coverage  required  by this paragraph shall not impose patient
    21  cost sharing for follow-up screening or  diagnostic  services  for  lung
    22  cancer.
    23    (C)  For  the purposes of this paragraph, "nationally recognized clin-
    24  ical practice guidelines" means evidence-based, peer  reviewed  clinical
    25  practice  guidelines  informed by a systematic review of evidence and an
    26  assessment of the  benefits,  and  risks  of  alternative  care  options
    27  intended to optimize patient care developed by independent organizations
    28  or  medical  professional  societies utilizing a transparent methodology
    29  and reporting structure and with a conflict of interest policy.
    30    (D) Nothing in this paragraph shall be construed  to  prevent  medical
    31  management  or utilization review of the services, including preauthori-
    32  zation, to ensure that such  services  are  consistent  with  nationally
    33  recognized  clinical  practice  guidelines  for  the  detection  of lung
    34  cancer.
    35    (E) If the policy is a high  deductible  health  plan  as  defined  in
    36  section  223(c)(2)  of  the Internal Revenue Code of 1986, such coverage
    37  may be subject to the plan's annual deductible if  application  of  this
    38  requirement would result in ineligibility for a health savings account.
    39    §  3.  Section  4303  of  the insurance law is amended by adding a new
    40  subsection (ww) to read as follows:
    41    (ww) (1) Every policy which provides medical, major medical, or  simi-
    42  lar  comprehensive-type  coverage  shall  provide coverage for follow-up
    43  screening or diagnostic services for lung cancer upon the recommendation
    44  of a health care provider acting within the provider's scope of practice
    45  pursuant to title eight of the education  law,  and  as  recommended  by
    46  nationally  recognized clinical practice guidelines for the detection of
    47  lung cancer.
    48    (2) Notwithstanding any  other  provision  of  law,  any  policy  that
    49  provides  coverage  required by this subsection shall not impose patient
    50  cost sharing for follow-up screening or  diagnostic  services  for  lung
    51  cancer.
    52    (3)  For  the purposes of this paragraph, "nationally recognized clin-
    53  ical practice guidelines" means evidence-based, peer  reviewed  clinical
    54  practice  guidelines  informed by a systematic review of evidence and an
    55  assessment of the  benefits,  and  risks  of  alternative  care  options
    56  intended to optimize patient care developed by independent organizations
        A. 1195--A                          3
 
     1  or  medical  professional  societies utilizing a transparent methodology
     2  and reporting structure and with a conflict of interest policy.
     3    (4)  Nothing  in  this paragraph shall be construed to prevent medical
     4  management or utilization review of the services, including  preauthori-
     5  zation,  to  ensure  that  such  services are consistent with nationally
     6  recognized clinical  practice  guidelines  for  the  detection  of  lung
     7  cancer.
     8    (5)  If  the  policy  is  a  high deductible health plan as defined in
     9  section 223(c)(2) of the Internal Revenue Code of  1986,  such  coverage
    10  may  be  subject  to the plan's annual deductible if application of this
    11  requirement would result in ineligibility for a health savings account.
    12    § 4. This act shall take effect January 1, 2027 and shall apply to all
    13  policies and contracts issued, renewed, modified, altered or amended  on
    14  or after such date.