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A02085 Summary:

BILL NOA02085A
 
SAME ASSAME AS S00906-B
 
SPONSORDinowitz
 
COSPNSRGalef, Cusick, Cymbrowitz, Zebrowski, Englebright, Rozic, McDonald, Fahy, Griffin, Simon, Sayegh, Rivera J, Hevesi, Abinanti, Ramos, Septimo, Otis, Lawler, Brabenec, Stirpe, Steck, Rosenthal L
 
MLTSPNSRBarnwell, Cahill, Colton, Cook, Glick, Gottfried
 
Amd §§3216 & 3221, Ins L
 
Requires certain providers of health care policies to provide coverage for colorectal cancer early detection in accordance with the American cancer society guidelines; requires the insurance carriers to notify enrollees of such coverage and screening guidelines via mail.
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A02085 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         2085--A
 
                               2021-2022 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 14, 2021
                                       ___________
 
        Introduced  by  M. of A. DINOWITZ, GALEF, CUSICK, CYMBROWITZ, ZEBROWSKI,
          ENGLEBRIGHT, ROZIC -- Multi-Sponsored by -- M. of A. BARNWELL, CAHILL,
          COLTON, COOK, GLICK, GOTTFRIED  --  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  providing  insurance
          coverage for colorectal cancer early detection
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Paragraph 27 of subsection  (i)  of  section  3216  of  the
     2  insurance  law,  as  added by chapter 457 of the laws of 2010, is renum-
     3  bered paragraph 36, paragraph 28 of subsection (i) of  section  3216  of
     4  the  insurance  law,  as  amended  by chapter 11 of the laws of 2012, is
     5  renumbered paragraph 37, paragraph 34 of subsection (i) of section  3216
     6  of the insurance law, as added by section 10 of part MM of chapter 57 of
     7  the laws of 2018, is renumbered paragraph 38 and a new paragraph 11-b is
     8  added to read as follows:
     9    (11-b) (A) Every policy delivered or issued for delivery in this state
    10  which  provides  medical  coverage  that includes coverage for physician
    11  services in a physician's office and every policy which  provides  major
    12  medical  or  similar comprehensive-type coverage shall provide, upon the
    13  prescription of a health care provider legally authorized  to  prescribe
    14  under  title  eight of the education law, coverage for colorectal cancer
    15  screening. The coverage required by this paragraph shall include preven-
    16  tive colorectal cancer screening  coverage  for  all  colorectal  cancer
    17  examinations  and  laboratory  tests  in accordance with American Cancer
    18  Society Guidelines for colorectal cancer screening of average risk indi-
    19  viduals, including an initial  colonoscopy  or  other  medical  test  or
    20  procedure  for  colorectal  cancer screening and a follow-up colonoscopy
    21  performed as a result of a positive result on a non-colonoscopy  preven-
    22  tive screening test.
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05478-04-1

        A. 2085--A                          2
 
     1    (B)  An  individual shall not be subject to a deductible, coinsurance,
     2  or any other cost-sharing  requirements  for  services  consistent  with
     3  subparagraph  (A)  of this paragraph received from participating provid-
     4  ers.
     5    § 2. Subsection (l) of section 3221 of the insurance law is amended by
     6  adding a new paragraph 11-b to read as follows:
     7    (11-b) (A) Every policy delivered or issued for delivery in this state
     8  which  provides  medical  coverage  that includes coverage for physician
     9  services in a physician's office and every policy which  provides  major
    10  medical  or  similar comprehensive-type coverage shall provide, upon the
    11  prescription of a health care provider legally authorized  to  prescribe
    12  under  title  eight of the education law, coverage for colorectal cancer
    13  screening.   The coverage  required  by  this  paragraph  shall  include
    14  preventive  colorectal  cancer  screening  coverage  for  all colorectal
    15  cancer examinations and laboratory tests  in  accordance  with  American
    16  Cancer  Society  Guidelines  for  colorectal cancer screening of average
    17  risk individuals, including an initial colonoscopy or other medical test
    18  or procedure for colorectal cancer screening and a follow-up colonoscopy
    19  performed as a result of a positive result on a non-colonoscopy  preven-
    20  tive screening test.
    21    (B)  An  individual shall not be subject to a deductible, coinsurance,
    22  or any other cost-sharing  requirements  for  services  consistent  with
    23  subparagraph  (A)  of this paragraph received from participating provid-
    24  ers.
    25    § 3. The superintendent of financial services shall require an  insur-
    26  er,  health  carrier or health benefit plan to notify enrollees annually
    27  of colorectal cancer screenings covered by such enrollees' health  bene-
    28  fit  plan  and  the  most  recently published guidelines of the American
    29  College of Gastroenterology or the American Gastroenterological  Associ-
    30  ation  in  consultation  with the American Cancer Society for colorectal
    31  cancer screenings or notify enrollees at intervals consistent  with  the
    32  most  recently published guidelines of the American College of Gastroen-
    33  terology or the American Gastroenterological Association in consultation
    34  with the American Cancer Society of colorectal cancer  screenings  which
    35  are  covered  by such enrollees' health benefit plans.  The notice shall
    36  be delivered by mail unless the enrollee and health carrier have  agreed
    37  on  another  method  of  notification.  The  superintendent of financial
    38  services is authorized to promulgate necessary rules and regulations for
    39  the purposes of providing such notification.
    40    § 4. This act shall take effect immediately and  shall  apply  to  any
    41  policy  issued,  delivered,  renewed,  and/or  modified  on or after the
    42  effective date of this act.
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