Bill Text: NY S00543 | 2013-2014 | General Assembly | Introduced
Bill Title: Requires providers of health care policies to provide coverage for colorectal cancer early detection for persons fifty years of age or older; requires the superintendent of insurance to provide notification to enrollees of such coverage via mail.
Sponsorship: Partisan Bill (Democrat 1)
Status: (Introduced - Dead) 2014-01-08 - REFERRED TO INSURANCE [S00543 Detail]
Download: New_York-2013-S00543-Introduced.html
S T A T E O F N E W Y O R K
________________________________________________________________________
543
2013-2014 Regular Sessions
I N S E N A T E
(PREFILED)
January 9, 2013
___________
Introduced by Sen. KENNEDY -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
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 30, 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 31 and a new paragraph 32 is added to read as
6 follows:
7 (32) (A) EVERY POLICY WHICH PROVIDES COVERAGE PURSUANT TO THIS SECTION
8 SHALL PROVIDE COVERAGE TO ANY NAMED SUBSCRIBER OR OTHER PERSON COVERED
9 THEREUNDER FOR EXPENSES INCURRED IN CONDUCTING COLORECTAL CANCER EXAM-
10 INATIONS AND LABORATORY TESTS AT REGULAR INTERVALS, INCLUDING EXPENSES
11 INCURRED IN CONDUCTING PHYSICIAN CONSULTATIONS FOR COLORECTAL CANCER
12 PRIOR TO SUCH EXAMINATIONS AND TESTS, FOR PERSONS FIFTY YEARS OF AGE OR
13 OLDER AND FOR PERSONS OF ANY AGE WHO ARE CONSIDERED TO BE AT HIGH RISK
14 FOR COLORECTAL CANCER. THE METHODS OF SCREENING FOR WHICH BENEFITS SHALL
15 BE PROVIDED SHALL INCLUDE BUT NOT BE LIMITED TO:
16 (I) A SCREENING FECAL OCCULT BLOOD TEST;
17 (II) FLEXIBLE SIGMOIDOSCOPY;
18 (III) COLONOSCOPY;
19 (IV) BARIUM ENEMA; OR
20 (V) THE MOST RELIABLE, MEDICALLY RECOGNIZED SCREENING TEST AVAILABLE;
21 AND
22 (VI) ANY COMBINATION THEREOF.
23 THE METHOD AND FREQUENCY OF SCREENING TO BE UTILIZED SHALL BE IN
24 ACCORD WITH THE MOST RECENTLY PUBLISHED GUIDELINES OF THE AMERICAN
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02479-02-3
S. 543 2
1 COLLEGE OF GASTROENTEROLOGY OR THE AMERICAN GASTROENTEROLOGICAL ASSOCI-
2 ATION IN CONSULTATION WITH THE AMERICAN CANCER SOCIETY.
3 (B) AS USED IN THIS PARAGRAPH, "HIGH RISK FOR COLORECTAL CANCER" SHALL
4 MEAN A PERSON HAS,
5 (I) A FAMILY HISTORY OF FAMILIAL ADENOMATOUS POLYPOSIS; HEREDITARY
6 NON-POLYPOSIS COLON CANCER; OR BREAST, OVARIAN, ENDOMETRIAL OR COLON
7 CANCER OR POLYPS;
8 (II) CHRONIC INFLAMMATORY BOWEL DISEASE; OR
9 (III) A BACKGROUND, ETHNICITY OR LIFESTYLE THAT THE PHYSICIAN BELIEVES
10 PUTS THE PERSON AT ELEVATED RISK FOR COLORECTAL CANCER.
11 S 2. Subsection (k) of section 3221 of the insurance law is amended by
12 adding a new paragraph 19 to read as follows:
13 (19) (A) EVERY POLICY WHICH PROVIDES COVERAGE PURSUANT TO THIS SECTION
14 SHALL PROVIDE COVERAGE TO ANY NAMED SUBSCRIBER OR OTHER PERSON COVERED
15 THEREUNDER FOR EXPENSES INCURRED IN CONDUCTING COLORECTAL CANCER EXAM-
16 INATIONS AND LABORATORY TESTS AT REGULAR INTERVALS, INCLUDING EXPENSES
17 INCURRED IN CONDUCTING PHYSICIAN CONSULTATIONS FOR COLORECTAL CANCER
18 PRIOR TO SUCH EXAMINATIONS AND TESTS, FOR PERSONS FIFTY YEARS OF AGE OR
19 OLDER AND FOR PERSONS OF ANY AGE WHO ARE CONSIDERED TO BE AT HIGH RISK
20 FOR COLORECTAL CANCER. THE METHODS OF SCREENING FOR WHICH BENEFITS SHALL
21 BE PROVIDED SHALL INCLUDE BUT NOT BE LIMITED TO:
22 (I) A SCREENING FECAL OCCULT BLOOD TEST;
23 (II) FLEXIBLE SIGMOIDOSCOPY;
24 (III) COLONOSCOPY;
25 (IV) BARIUM ENEMA; OR
26 (V) THE MOST RELIABLE, MEDICALLY RECOGNIZED SCREENING TEST AVAILABLE;
27 AND
28 (VI) ANY COMBINATION THEREOF.
29 THE METHOD AND FREQUENCY OF SCREENING TO BE UTILIZED SHALL BE IN
30 ACCORD WITH THE MOST RECENTLY PUBLISHED GUIDELINES OF THE AMERICAN
31 COLLEGE OF GASTROENTEROLOGY OR THE AMERICAN GASTROENTEROLOGICAL ASSOCI-
32 ATION IN CONSULTATION WITH THE AMERICAN CANCER SOCIETY.
33 (B) AS USED IN THIS PARAGRAPH, "HIGH RISK FOR COLORECTAL CANCER" SHALL
34 MEAN A PERSON HAS,
35 (I) A FAMILY HISTORY OF FAMILIAL ADENOMATOUS POLYPOSIS; HEREDITARY
36 NON-POLYPOSIS COLON CANCER; OR BREAST, OVARIAN, ENDOMETRIAL OR COLON
37 CANCER OR POLYPS;
38 (II) CHRONIC INFLAMMATORY BOWEL DISEASE; OR
39 (III) A BACKGROUND, ETHNICITY OR LIFESTYLE THAT THE PHYSICIAN BELIEVES
40 PUTS THE PERSON AT ELEVATED RISK FOR COLORECTAL CANCER.
41 S 3. Subsection (a) of section 4303 of the insurance law is amended by
42 adding a new paragraph 4 to read as follows:
43 (4) TO PERSONS FIFTY YEARS OF AGE OR OLDER FOR SERVICES RELATED TO THE
44 CONDUCTING OF COLORECTAL CANCER EXAMINATIONS AND LABORATORY TESTS AT
45 REGULAR INTERVALS, INCLUDING EXPENSES INCURRED IN CONDUCTING PHYSICIAN
46 CONSULTATIONS FOR COLORECTAL CANCER PRIOR TO SUCH EXAMINATIONS AND
47 TESTS, INCLUDING BUT NOT LIMITED TO, COLONOSCOPIES, COLOSCOPIES, SCREEN-
48 ING FECAL OCCULT BLOOD TESTS, FLEXIBLE SIGMOIDOSCOPIES OR BARIUM ENEMAS.
49 S 4. The superintendent of financial services shall require an insur-
50 er, health carrier or health benefit plan to notify enrollees annually
51 of colorectal cancer screenings covered by such enrollees' health bene-
52 fit plan and the most recently published guidelines of the American
53 College of Gastroenterology or the American Gastroenterological Associ-
54 ation in consultation with the American Cancer Society for colorectal
55 cancer screenings or notify enrollees at intervals consistent with the
56 most recently published guidelines of the American College of Gastroen-
S. 543 3
1 terology or the American Gastroenterological Association in consultation
2 with the American Cancer Society of colorectal cancer screenings which
3 are covered by such enrollees' health benefit plans. The notice shall
4 be delivered by mail unless the enrollee and health carrier have agreed
5 on another method of notification. The superintendent of financial
6 services is authorized to promulgate necessary rules and regulations for
7 the purposes of providing such notification.
8 S 5. This act shall take effect immediately and shall apply to any
9 policy issued, delivered, renewed, and/or modified on or after the
10 effective date of this act.
