Provides that every health insurance policy which provides coverage for hospital, surgical or medical care shall provide coverage for the standard diagnostic testing for ovarian cancer upon the recommendation of a physician; provides that such standard diagnostic testing shall include a pelvic examination, a sonogram and a CA 125 blood test and related laboratory and diagnostic services.
STATE OF NEW YORK
________________________________________________________________________
2521
2009-2010 Regular Sessions
IN ASSEMBLY
January 16, 2009
___________
Introduced by M. of A. PRETLOW, JOHN, JAFFEE, GREENE -- Multi-Sponsored
by -- M. of A. BING, CAHILL, CLARK, COOK, CUSICK, DESTITO, DINOWITZ,
GALEF, GLICK, HOOPER, HOYT, JACOBS, V. LOPEZ, MAGEE, MAYERSOHN, MILL-
MAN, ORTIZ, PERRY, SCARBOROUGH, SWEENEY, TOWNS, WEINSTEIN, WEISENBERG,
WRIGHT -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to health insurance
coverage for diagnostic 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-b to read as follows:
3 (11-b) (A) Every policy delivered or issued for delivery in this state
4 which provides medical coverage that includes coverage for physician
5 services in a physician's office and every policy which provides major
6 medical or similar comprehensive-type coverage shall provide, upon the
7 prescription of a health care provider legally authorized to prescribe
8 under title eight of the education law, coverage for diagnostic testing
9 for ovarian cancer, including a pelvic examination, a sonogram, a CA 125
10 blood test and laboratory and diagnostic services provided in connection
11 with examining and evaluating such blood test for women aged forty and
12 over with one or more female relatives with a prior history of ovarian
13 cancer.
14 (B) Such coverage may be subject to annual deductibles and coinsurance
15 as may be deemed appropriate by the superintendent and as are consistent
16 with those established for other benefits within a given policy.
17 § 2. Subsection (l) of section 3221 of the insurance law is amended by
18 adding a new paragraph 11-b to read as follows:
19 (11-b) (A) Every insurer which delivers or issues for delivery in this
20 state a policy which provides medical coverage that includes coverage
21 for physician services in a physician's office or major medical or simi-
22 lar comprehensive-type coverage shall provide, upon the prescription of
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD01352-01-9
A. 2521 2
1 a health care provider legally authorized to prescribe under title eight
2 of the education law, coverage for diagnostic testing for ovarian
3 cancer, including a pelvic examination, a sonogram, a CA 125 blood test
4 and laboratory and diagnostic services provided in connection with exam-
5 ining and evaluating such blood test for women aged forty and over with
6 one or more female relatives with a prior history of ovarian cancer.
7 (B) Such coverage may be subject to annual deductibles and coinsurance
8 as may be deemed appropriate by the superintendent and as are consistent
9 with those established for other benefits within a given policy.
10 § 3. Section 4303 of the insurance law is amended by adding a new
11 subsection (ff) to read as follows:
12 (ff) (1) A hospital service corporation, medical expense indemnity
13 corporation or health service corporation which provides medical cover-
14 age that includes coverage for physician services in a physician's
15 office or major medical or similar comprehensive-type coverage shall
16 provide, upon the prescription of a health care provider legally author-
17 ized to prescribe under title eight of the education law, coverage for
18 diagnostic testing for ovarian cancer, including a pelvic examination, a
19 sonogram, a CA 125 blood test and laboratory and diagnostic services
20 provided in connection with examining and evaluating such blood test for
21 women aged forty and over with one or more female relatives with a prior
22 history of ovarian cancer.
23 (2) Such coverage may be subject to annual deductibles and coinsurance
24 as may be deemed appropriate by the superintendent and as are consistent
25 with those established for other benefits within a given policy.
26 § 4. This act shall take effect on the first of January next succeed-
27 ing the date on which it shall have become a law and shall apply to all
28 policies issued, renewed, altered or modified on or after such effective
29 date.
