Requires that insurance companies provide coverage for surveillance tests for ovarian cancer of insured individuals who are deemed to be at risk for ovarian cancer.
STATE OF NEW YORK
________________________________________________________________________
1916
2013-2014 Regular Sessions
IN ASSEMBLY(Prefiled)
January 9, 2013
___________
Introduced by M. of A. ORTIZ, JACOBS, COOK, COLTON, CLARK, GUNTHER,
PEOPLES-STOKES, CAMARA, MILLMAN, BOYLAND, CAHILL, ENGLEBRIGHT --
Multi-Sponsored by -- M. of A. BRENNAN, FARRELL, GOTTFRIED, LUPARDO,
RIVERA, WEISENBERG -- read once and referred to the Committee on
Insurance
AN ACT to amend the insurance law, in relation to providing coverage for
surveillance tests 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 30 to read as follows:
3 (30) Every policy that provides medical, major-medical or similar
4 comprehensive-type coverage shall provide coverage for surveillance
5 tests for ovarian cancer for an insured who is at risk for ovarian
6 cancer. (A) For purposes of this subsection, an insured is deemed to be
7 at risk if:
8 (i) she has a family history of:
9 1. one or more first-degree relative with ovarian cancer;
10 2. three or more female relatives with breast cancer; or
11 3. nonpolyposis colorectal cancer; or
12 (ii) she tests positive for BRCA1 or BRCA2 mutations.
13 (B) For purposes of this subsection, surveillance tests for ovarian
14 cancer shall mean annual screening for ovarian cancer using:
15 (i) CA-125 serum tumor marker testing;
16 (ii) transvaginal ultrasound; and
17 (iii) pelvic examination.
18 § 2. Subsection (k) of section 3221 of the insurance law is amended by
19 adding a new paragraph 19 to read as follows:
20 (19) Every group or blanket policy delivered or issued for delivery in
21 this state which provides hospital, surgical or medical coverage shall
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD04283-01-3
A. 1916 2
1 include coverage for surveillance tests for ovarian cancer for an
2 insured who is at risk for ovarian cancer. (A) For purposes of this
3 subsection, an insured is deemed to be at risk if:
4 (i) she has a family history of:
5 1. one or more first-degree relative with ovarian cancer;
6 2. three or more female relatives with breast cancer; or
7 3. nonpolyposis colorectal cancer; or
8 (ii) she tests positive for BRCA1 or BRCA2 mutations.
9 (B) For purposes of this subsection, surveillance tests for ovarian
10 cancer shall mean annual screening for ovarian cancer using:
11 (i) CA-125 serum tumor marker testing;
12 (ii) transvaginal ultrasound; and
13 (iii) pelvic examination.
14 § 3. Section 4303 of the insurance law is amended by adding a new
15 subsection (jj) to read as follows:
16 (jj) A health service corporation or medical expense indemnity corpo-
17 ration which provides medical, major-medical or similar comprehensive-
18 type coverage must provide coverage for surveillance tests for ovarian
19 cancer for an insured who is at risk for ovarian cancer. (1) For
20 purposes of this subsection, an insured is deemed to be at risk if:
21 (A) she has a family history of:
22 (i) one or more first-degree relative with ovarian cancer;
23 (ii) three or more female relatives with breast cancer; or
24 (iii) nonpolyposis colorectal cancer; or
25 (B) she tests positive for BRCA1 or BRCA2 mutations.
26 (2) For purposes of this subsection, surveillance tests for ovarian
27 cancer shall mean annual screening for ovarian cancer using:
28 (A) CA-125 serum tumor marker testing;
29 (B) transvaginal ultrasound; and
30 (C) pelvic examination.
31 § 4. This act shall take effect immediately and shall apply to any
32 policy issued, renewed, or modified after such effective date.
