STATE OF NEW YORK
________________________________________________________________________
323
2015-2016 Regular Sessions
IN ASSEMBLY(Prefiled)
January 7, 2015
___________
Introduced by M. of A. ROZIC, CRESPO, AUBRY, ABINANTI, BORELLI, COLTON,
COOK, GRAF, GUNTHER, JAFFEE, LUPINACCI, MONTESANO, MOYA, OTIS, PERRY,
ROBINSON, SCARBOROUGH, SEPULVEDA, SKOUFIS, STECK, TITUS, WEPRIN --
Multi-Sponsored by -- M. of A. ARROYO, BRENNAN, CERETTO, CLARK,
CROUCH, MAGEE, MOSLEY, RA, RIVERA, ROBERTS, SCHIMEL, SIMANOWITZ, SKAR-
TADOS, TITONE -- 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
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD01732-01-5
A. 323 2
1 person is believed to be at increased risk for ovarian cancer due to
2 family history or prior personal history of ovarian cancer, positive
3 genetic testing or other indications as determined by such person's
4 physician or nurse practitioner.
5 (ii) Such additional coverage may be subject to annual deductibles and
6 coinsurance as may be deemed appropriate by the superintendent and as
7 are consistent with those established for other benefits within a given
8 policy.
9 § 2. Subsection (l) of section 3221 of the insurance law is amended by
10 adding a new paragraph 11-b to read as follows:
11 (11-b) (A) Every insurer delivering a group or blanket policy or issu-
12 ing a group or blanket policy for delivery in this state that provides
13 coverage for hospital, surgical or medical care shall provide the
14 following coverage for screening for ovarian cancer:
15 (i) upon the recommendation of a physician, a pelvic exam, genetic
16 testing, ultrasound and blood testing at any age for covered persons
17 having a high risk of developing ovarian cancer or who have a first
18 degree relative with a prior history of ovarian cancer;
19 (ii) a single baseline ultrasound for covered persons aged thirty-five
20 through thirty-nine, inclusive; and
21 (iii) an annual ultrasound for covered persons aged forty and older.
22 (B) Such coverage required pursuant to subparagraph (A) of this para-
23 graph may be subject to annual deductibles and coinsurance as may be
24 deemed appropriate by the superintendent and as are consistent with
25 those established for other benefits within a given policy.
26 (C) (i) Such policy shall provide for additional coverage for computed
27 tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-
28 tron emission tomography, laparoscopy, colonoscopy and biopsy if a
29 person is believed to be at increased risk for ovarian cancer due to
30 family history or prior personal history of ovarian cancer, positive
31 genetic testing or other indications as determined by such person's
32 physician or nurse practitioner.
33 (ii) Such additional coverage may be subject to annual deductibles and
34 coinsurance as may be deemed appropriate by the superintendent and as
35 are consistent with those established for other benefits within a given
36 policy.
37 § 3. Section 4303 of the insurance law is amended by adding a new
38 subsection (p-1) to read as follows:
39 (p-1) (1) A medical expense indemnity corporation, a hospital service
40 corporation or a health service corporation that provides coverage for
41 hospital, surgical or medical care shall provide the following coverage
42 for screening for ovarian cancer:
43 (A) upon the recommendation of a physician, a pelvic exam, genetic
44 testing, ultrasound and blood testing at any age for covered persons
45 having a high risk of developing ovarian cancer or who have a first
46 degree relative with a prior history of ovarian cancer;
47 (B) a single baseline ultrasound for covered persons aged thirty-five
48 through thirty-nine, inclusive; and
49 (C) an annual ultrasound for covered persons aged forty and older.
50 (2) Such coverage required pursuant to subparagraph (A) of this para-
51 graph may be subject to annual deductibles and coinsurance as may be
52 deemed appropriate by the superintendent and as are consistent with
53 those established for other benefits within a given policy.
54 (3) (A) Such policy shall provide for additional coverage for computed
55 tomography, barium enema X-rays, magnetic resonance imaging (MRI), posi-
56 tron emission tomography, laparoscopy, colonoscopy and biopsy if a
A. 323 3
1 person is believed to be at increased risk for ovarian cancer due to
2 family history or prior personal history of ovarian cancer, positive
3 genetic testing or other indications as determined by such person's
4 physician or nurse practitioner.
5 (B) Such additional coverage may be subject to annual deductibles and
6 coinsurance as may be deemed appropriate by the superintendent and as
7 are consistent with those established for other benefits within a given
8 policy.
9 § 4. This act shall take effect on the sixtieth day after it shall
10 have become a law.