Bill Text: NY S02380 | 2009-2010 | 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.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2010-01-06 - REFERRED TO INSURANCE [S02380 Detail]

Download: New_York-2009-S02380-Introduced.html

---

                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         2380
                              2009-2010 Regular Sessions
                                   I N  S E N A T E
                                   February 19, 2009
                                      ___________
       Introduced  by  Sen. PADAVAN -- 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. Subsection (i) of section 3216  of  the  insurance  law  is
    2  amended by adding a new paragraph 26 to read as follows:
    3    (26) (A) EVERY POLICY WHICH PROVIDES COVERAGE PURSUANT TO THIS SECTION
    4  SHALL  PROVIDE  COVERAGE TO ANY NAMED SUBSCRIBER OR OTHER PERSON COVERED
    5  THEREUNDER FOR EXPENSES INCURRED IN CONDUCTING COLORECTAL  CANCER  EXAM-
    6  INATIONS  AND  LABORATORY TESTS AT REGULAR INTERVALS, INCLUDING EXPENSES
    7  INCURRED IN CONDUCTING PHYSICIAN  CONSULTATIONS  FOR  COLORECTAL  CANCER
    8  PRIOR  TO SUCH EXAMINATIONS AND TESTS, FOR PERSONS FIFTY YEARS OF AGE OR
    9  OLDER AND FOR PERSONS OF ANY AGE WHO ARE CONSIDERED TO BE AT  HIGH  RISK
   10  FOR COLORECTAL CANCER. THE METHODS OF SCREENING FOR WHICH BENEFITS SHALL
   11  BE PROVIDED SHALL INCLUDE BUT NOT BE LIMITED TO:
   12    (I) A SCREENING FECAL OCCULT BLOOD TEST;
   13    (II) FLEXIBLE SIGMOIDOSCOPY;
   14    (III) COLONOSCOPY;
   15    (IV) BARIUM ENEMA; OR
   16    (V)  THE MOST RELIABLE, MEDICALLY RECOGNIZED SCREENING TEST AVAILABLE;
   17  AND
   18    (VI) ANY COMBINATION THEREOF.
   19    THE METHOD AND FREQUENCY OF SCREENING  TO  BE  UTILIZED  SHALL  BE  IN
   20  ACCORD  WITH  THE  MOST  RECENTLY  PUBLISHED  GUIDELINES OF THE AMERICAN
   21  COLLEGE OF GASTROENTEROLOGY OR THE AMERICAN GASTROENTEROLOGICAL  ASSOCI-
   22  ATION IN CONSULTATION WITH THE AMERICAN CANCER SOCIETY.
   23    (B) AS USED IN THIS PARAGRAPH, "HIGH RISK FOR COLORECTAL CANCER" SHALL
   24  MEAN A PERSON HAS,
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02732-01-9
       S. 2380                             2
    1    (I)  A  FAMILY  HISTORY  OF FAMILIAL ADENOMATOUS POLYPOSIS; HEREDITARY
    2  NON-POLYPOSIS COLON CANCER; OR BREAST,  OVARIAN,  ENDOMETRIAL  OR  COLON
    3  CANCER OR POLYPS;
    4    (II) CHRONIC INFLAMMATORY BOWEL DISEASE; OR
    5    (III) A BACKGROUND, ETHNICITY OR LIFESTYLE THAT THE PHYSICIAN BELIEVES
    6  PUTS THE PERSON AT ELEVATED RISK FOR COLORECTAL CANCER.
    7    S 2. Subsection (k) of section 3221 of the insurance law is amended by
    8  adding a new paragraph 15 to read as follows:
    9    (15) (A) EVERY POLICY WHICH PROVIDES COVERAGE PURSUANT TO THIS SECTION
   10  SHALL  PROVIDE  COVERAGE TO ANY NAMED SUBSCRIBER OR OTHER PERSON COVERED
   11  THEREUNDER FOR EXPENSES INCURRED IN CONDUCTING COLORECTAL  CANCER  EXAM-
   12  INATIONS  AND  LABORATORY TESTS AT REGULAR INTERVALS, INCLUDING EXPENSES
   13  INCURRED IN CONDUCTING PHYSICIAN  CONSULTATIONS  FOR  COLORECTAL  CANCER
   14  PRIOR  TO SUCH EXAMINATIONS AND TESTS, FOR PERSONS FIFTY YEARS OF AGE OR
   15  OLDER AND FOR PERSONS OF ANY AGE WHO ARE CONSIDERED TO BE AT  HIGH  RISK
   16  FOR COLORECTAL CANCER. THE METHODS OF SCREENING FOR WHICH BENEFITS SHALL
   17  BE PROVIDED SHALL INCLUDE BUT NOT BE LIMITED TO:
   18    (I) A SCREENING FECAL OCCULT BLOOD TEST;
   19    (II) FLEXIBLE SIGMOIDOSCOPY;
   20    (III) COLONOSCOPY;
   21    (IV) BARIUM ENEMA; OR
   22    (V)  THE MOST RELIABLE, MEDICALLY RECOGNIZED SCREENING TEST AVAILABLE;
   23  AND
   24    (VI) ANY COMBINATION THEREOF.
   25    THE METHOD AND FREQUENCY OF SCREENING  TO  BE  UTILIZED  SHALL  BE  IN
   26  ACCORD  WITH  THE  MOST  RECENTLY  PUBLISHED  GUIDELINES OF THE AMERICAN
   27  COLLEGE OF GASTROENTEROLOGY OR THE AMERICAN GASTROENTEROLOGICAL  ASSOCI-
   28  ATION IN CONSULTATION WITH THE AMERICAN CANCER SOCIETY.
   29    (B) AS USED IN THIS PARAGRAPH, "HIGH RISK FOR COLORECTAL CANCER" SHALL
   30  MEAN A PERSON HAS,
   31    (I)  A  FAMILY  HISTORY  OF FAMILIAL ADENOMATOUS POLYPOSIS; HEREDITARY
   32  NON-POLYPOSIS COLON CANCER; OR BREAST,  OVARIAN,  ENDOMETRIAL  OR  COLON
   33  CANCER OR POLYPS;
   34    (II) CHRONIC INFLAMMATORY BOWEL DISEASE; OR
   35    (III) A BACKGROUND, ETHNICITY OR LIFESTYLE THAT THE PHYSICIAN BELIEVES
   36  PUTS THE PERSON AT ELEVATED RISK FOR COLORECTAL CANCER.
   37    S 3. Subsection (a) of section 4303 of the insurance law is amended by
   38  adding a new paragraph 4 to read as follows:
   39    (4) TO PERSONS FIFTY YEARS OF AGE OR OLDER FOR SERVICES RELATED TO THE
   40  CONDUCTING  OF  COLORECTAL  CANCER  EXAMINATIONS AND LABORATORY TESTS AT
   41  REGULAR INTERVALS, INCLUDING EXPENSES INCURRED IN  CONDUCTING  PHYSICIAN
   42  CONSULTATIONS  FOR  COLORECTAL  CANCER  PRIOR  TO  SUCH EXAMINATIONS AND
   43  TESTS, INCLUDING BUT NOT LIMITED TO, COLONOSCOPIES, COLOSCOPIES, SCREEN-
   44  ING FECAL OCCULT BLOOD TESTS, FLEXIBLE SIGMOIDOSCOPIES OR BARIUM ENEMAS.
   45    S 4. The superintendent of insurance shall require an insurer,  health
   46  carrier  or health benefit plan to notify enrollees annually of colorec-
   47  tal cancer screenings covered by such enrollees' health benefit plan and
   48  the most recently  published  guidelines  of  the  American  College  of
   49  Gastroenterology  or  the  American  Gastroenterological  Association in
   50  consultation with the American  Cancer  Society  for  colorectal  cancer
   51  screenings  or  notify  enrollees  at intervals consistent with the most
   52  recently published guidelines of the American College of Gastroenterolo-
   53  gy or the American Gastroenterological Association in consultation  with
   54  the  American  Cancer  Society of colorectal cancer screenings which are
   55  covered by such enrollees' health benefit plans.   The notice  shall  be
   56  delivered  by mail unless the enrollee and health carrier have agreed on
       S. 2380                             3
    1  another method of  notification.  The  superintendent  of  insurance  is
    2  authorized  to  promulgate  necessary  rules  and  regulations  for  the
    3  purposes of providing such notification.
    4    S  5.  This  act  shall take effect immediately and shall apply to any
    5  policy issued, delivered, renewed,  and/or  modified  on  or  after  the
    6  effective date of this act.