Bill Text: NY A11279 | 2017-2018 | General Assembly | Introduced

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Bill Title: Requires dihydropyrimidine dehydrogenase deficiency testing prior to fluoropyrmidine or other antimetabolite treatment; requires policies and contracts of insurance to include coverage for dihydropyrimidine dehydrogenase deficiency testing; provides for dihydropyrimidine dehydrogenase deficiency testing under the medical assistance program.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2018-07-25 - referred to health [A11279 Detail]

Download: New_York-2017-A11279-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                          11279
                   IN ASSEMBLY
                                      July 25, 2018
                                       ___________
        Introduced  by  COMMITTEE  ON  RULES -- (at request of M. of A. Fahy) --
          read once and referred to the Committee on Health
        AN ACT to amend the public health law, in relation to requiring dihydro-
          pyrimidine dehydrogenase deficiency testing  for  certain  individuals
          with  cancer;  to  amend  the  insurance law, in relation to requiring
          policies and contracts of insurance to include coverage for dihydropy-
          rimidine dehydrogenase deficiency testing; and  to  amend  the  social
          services law, in relation to the provision of dihydropyrimidine dehyd-
          rogenase deficiency testing under the medical assistance program
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. The public health law is amended by adding  a  new  section
     2  2400-a to read as follows:
     3    §  2400-a.  Dihydropyrimidine dehydrogenase deficiency testing. 1. For
     4  purposes of this section the following terms shall  have  the  following
     5  meanings:
     6    (a)  "Antimetabolites"  means  a  substance  that  interferes with the
     7  normal metabolic processes within cells,  typically  by  combining  with
     8  enzymes.
     9    (b)  "Dihydropyrimidine dehydrogenase deficiency" means a condition in
    10  which the body cannot break down the nucleotides thymine and uracil.
    11    (c) "Fluoropyrmidine" means a group of substances used to treat cancer
    12  through chemotherapy.
    13    2. Every physician or other authorized practitioner who provides fluo-
    14  ropyrmidine or  other  antimetabolites  to  individuals  diagnosed  with
    15  cancer  shall  test for dihydropyrimidine dehydrogenase deficiency prior
    16  to such treatment.
    17    § 2. Subparagraph (A) of paragraph 12-a of subsection (i)  of  section
    18  3216 of the insurance law, as amended by chapter 12 of the laws of 2012,
    19  is amended to read as follows:
    20    (A)  Every  policy delivered or issued for delivery in this state that
    21  provides medical, major medical, or similar comprehensive-type  coverage
    22  and  provides coverage for prescription drugs and also provides coverage
    23  for cancer chemotherapy treatment shall provide coverage for prescribed,
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD14490-01-8
        A. 11279                            2
     1  orally administered anticancer medications used  to  kill  or  slow  the
     2  growth of cancerous cells, and shall provide coverage for dihydropyrimi-
     3  dine dehydrogenase deficiency testing prior to such treatment where such
     4  treatment  consists  of  fluoropyrmidine  or other antimetabolites. Such
     5  coverage may be subject to co-pays, coinsurance or deductibles, provided
     6  that the co-pays, coinsurance or deductibles are at least  as  favorable
     7  to  an  insured as the co-pays, coinsurance or deductibles that apply to
     8  coverage for intravenous or injected anticancer medications.
     9    § 3. Subparagraph (A) of paragraph 12-a of subsection (l)  of  section
    10  3221 of the insurance law, as amended by chapter 12 of the laws of 2012,
    11  is amended to read as follows:
    12    (A)  Every  policy delivered or issued for delivery in this state that
    13  provides medical, major medical, or similar comprehensive-type  coverage
    14  and  provides coverage for prescription drugs and also provides coverage
    15  for cancer chemotherapy treatment shall provide coverage for prescribed,
    16  orally administered anticancer medications used  to  kill  or  slow  the
    17  growth of cancerous cells, and shall provide coverage for dihydropyrimi-
    18  dine dehydrogenase deficiency testing prior to such treatment where such
    19  treatment  consists  of  fluoropyrmidine  or other antimetabolites. Such
    20  coverage may be subject to co-pays, coinsurance or deductibles, provided
    21  that the co-pays, coinsurance or deductibles are at least  as  favorable
    22  to  an  insured as the co-pays, coinsurance or deductibles that apply to
    23  coverage for intravenous or injected anticancer medications.
    24    § 4. Paragraph 1 of subsection (q-1) of section 4303 of the  insurance
    25  law, as amended by chapter 12 of the laws of 2012, is amended to read as
    26  follows:
    27    (1)  Every contract issued by a medical expense indemnity corporation,
    28  a hospital service corporation  or  a  health  service  corporation  for
    29  delivery  in  this state that provides medical, major medical or similar
    30  comprehensive-type coverage and provides coverage for prescription drugs
    31  and  for  cancer  chemotherapy  treatment  shall  provide  coverage  for
    32  prescribed,  orally  administered anticancer medications used to kill or
    33  slow the growth of cancerous cells, and shall provide coverage for dihy-
    34  dropyrimidine dehydrogenase deficiency testing prior to  such  treatment
    35  where  such  treatment consists of fluoropyrmidine or other antimetabol-
    36  ites. Such coverage may be subject to co-pays,  coinsurance  or  deduct-
    37  ibles,  provided  that  the  co-pays,  coinsurance or deductibles are at
    38  least as favorable to an insured as the co-pays, coinsurance or  deduct-
    39  ibles  that  apply  to  coverage  for intravenous or injected anticancer
    40  medications.
    41    § 5. The social services law is amended by adding a new section  365-o
    42  to read as follows:
    43    § 365-o. Provision of dihydropyrimidine dehydrogenase deficiency test-
    44  ing.  1.   The commissioner shall establish standards and guidelines for
    45  the provision  of  dihydropyrimidine  dehydrogenase  deficiency  testing
    46  prior  to cancer treatment through fluoropyrmidine or other antimetabol-
    47  ites under the medical assistance program.
    48    2. For purposes of this section:
    49    (a) "Antimetabolites" means  a  substance  that  interferes  with  the
    50  normal  metabolic  processes  within  cells, typically by combining with
    51  enzymes.
    52    (b) "Dihydropyrimidine dehydrogenase deficiency" means a condition  in
    53  which the body cannot break down the nucleotides thymine and uracil.
    54    (c) "Fluoropyrmidine" means a group of substances used to treat cancer
    55  through chemotherapy.
        A. 11279                            3
     1    § 6. This act shall take effect on the one hundred twentieth day after
     2  it  shall have become a law. Effective immediately, the addition, amend-
     3  ment and/or repeal of any rule or regulation necessary for the implemen-
     4  tation of this act on its effective date are authorized to be  made  and
     5  completed on or before such effective date.