Bill Text: NY A05651 | 2019-2020 | General Assembly | Introduced

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Bill Title: Requires health insurance policies to cover comprehensive screening for ovarian cancer.

Spectrum: Partisan Bill (Democrat 21-1)

Status: (Introduced - Dead) 2020-01-08 - referred to insurance [A05651 Detail]

Download: New_York-2019-A05651-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          5651
                               2019-2020 Regular Sessions
                   IN ASSEMBLY
                                    February 14, 2019
                                       ___________
        Introduced by M. of A. ROZIC, PEOPLES-STOKES, AUBRY, ABINANTI, BARNWELL,
          BLAKE,  COLTON,  COOK,  CRESPO,  D'URSO, GUNTHER, JAFFEE, JONES, OTIS,
          PERRY, SIMON, STECK, TITUS, WEPRIN, MONTESANO,  M. G. MILLER  --  read
          once and referred to the Committee on Insurance
        AN  ACT  to  amend  the  insurance  law, in relation to requiring health
          insurance policies to cover comprehensive tests for ovarian cancer  in
          certain cases
          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 that provides coverage for hospital, surgical
     4  or medical care shall provide the following coverage for  screening  for
     5  ovarian cancer:
     6    (i)  upon  the  recommendation  of a physician, a pelvic exam, genetic
     7  testing, ultrasound and blood testing at any  age  for  covered  persons
     8  having  a  high  risk  of  developing ovarian cancer or who have a first
     9  degree relative with a prior history of ovarian cancer;
    10    (ii) a single baseline ultrasound for covered persons aged thirty-five
    11  through thirty-nine, inclusive; and
    12    (iii) an annual ultrasound for covered persons aged forty and older.
    13    (B) Such coverage required pursuant to subparagraph (A) of this  para-
    14  graph  may  be  subject  to annual deductibles and coinsurance as may be
    15  deemed appropriate by the superintendent  and  as  are  consistent  with
    16  those established for other benefits within a given policy.
    17    (C) (i) Such policy shall provide for additional coverage for computed
    18  tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-
    19  tron  emission  tomography,  laparoscopy,  colonoscopy  and  biopsy if a
    20  person is believed to be at increased risk for  ovarian  cancer  due  to
    21  family  history  or  prior  personal history of ovarian cancer, positive
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD01112-01-9
        A. 5651                             2
     1  genetic testing or other indications  as  determined  by  such  person's
     2  physician or nurse practitioner.
     3    (ii) Such additional coverage may be subject to annual deductibles and
     4  coinsurance  as  may  be deemed appropriate by the superintendent and as
     5  are consistent with those established for other benefits within a  given
     6  policy.
     7    § 2. Subsection (l) of section 3221 of the insurance law is amended by
     8  adding a new paragraph 11-b to read as follows:
     9    (11-b) (A) Every insurer delivering a group or blanket policy or issu-
    10  ing  a  group or blanket policy for delivery in this state that provides
    11  coverage for hospital,  surgical  or  medical  care  shall  provide  the
    12  following coverage for screening for ovarian cancer:
    13    (i)  upon  the  recommendation  of a physician, a pelvic exam, genetic
    14  testing, ultrasound and blood testing at any  age  for  covered  persons
    15  having  a  high  risk  of  developing ovarian cancer or who have a first
    16  degree relative with a prior history of ovarian cancer;
    17    (ii) a single baseline ultrasound for covered persons aged thirty-five
    18  through thirty-nine, inclusive; and
    19    (iii) an annual ultrasound for covered persons aged forty and older.
    20    (B) Such coverage required pursuant to subparagraph (A) of this  para-
    21  graph  may  be  subject  to annual deductibles and coinsurance as may be
    22  deemed appropriate by the superintendent  and  as  are  consistent  with
    23  those established for other benefits within a given policy.
    24    (C) (i) Such policy shall provide for additional coverage for computed
    25  tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-
    26  tron  emission  tomography,  laparoscopy,  colonoscopy  and  biopsy if a
    27  person is believed to be at increased risk for  ovarian  cancer  due  to
    28  family  history  or  prior  personal history of ovarian cancer, positive
    29  genetic testing or other indications  as  determined  by  such  person's
    30  physician or nurse practitioner.
    31    (ii) Such additional coverage may be subject to annual deductibles and
    32  coinsurance  as  may  be deemed appropriate by the superintendent and as
    33  are consistent with those established for other benefits within a  given
    34  policy.
    35    §  3.  Section  4303  of  the insurance law is amended by adding a new
    36  subsection (p-1) to read as follows:
    37    (p-1) (1) A medical expense indemnity corporation, a hospital  service
    38  corporation  or  a health service corporation that provides coverage for
    39  hospital, surgical or medical care shall provide the following  coverage
    40  for screening for ovarian cancer:
    41    (A)  upon  the  recommendation  of a physician, a pelvic exam, genetic
    42  testing, ultrasound and blood testing at any  age  for  covered  persons
    43  having  a  high  risk  of  developing ovarian cancer or who have a first
    44  degree relative with a prior history of ovarian cancer;
    45    (B) a single baseline ultrasound for covered persons aged  thirty-five
    46  through thirty-nine, inclusive; and
    47    (C) an annual ultrasound for covered persons aged forty and older.
    48    (2)  Such coverage required pursuant to subparagraph (A) of this para-
    49  graph may be subject to annual deductibles and  coinsurance  as  may  be
    50  deemed  appropriate  by  the  superintendent  and as are consistent with
    51  those established for other benefits within a given policy.
    52    (3) (A) Such policy shall provide for additional coverage for computed
    53  tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-
    54  tron emission tomography,  laparoscopy,  colonoscopy  and  biopsy  if  a
    55  person  is  believed  to  be at increased risk for ovarian cancer due to
    56  family history or prior personal history  of  ovarian  cancer,  positive
        A. 5651                             3
     1  genetic  testing  or  other  indications  as determined by such person's
     2  physician or nurse practitioner.
     3    (B)  Such additional coverage may be subject to annual deductibles and
     4  coinsurance as may be deemed appropriate by the  superintendent  and  as
     5  are  consistent with those established for other benefits within a given
     6  policy.
     7    § 4. This act shall take effect on the sixtieth  day  after  it  shall
     8  have become a law.