NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A5651
SPONSOR: Rozic TITLE OF BILL:
An act to amend the insurance law, in relation to requiring health
insurance policies to cover comprehensive tests for ovarian cancer in
certain cases
PURPOSE:
To require insurance companies to include coverage for screening for
ovarian cancer upon the recommendation of a physician.
SUMMARY OF PROVISIONS:
Section 1 amends subsection (i) of section 3216 of the insurance law is
amended by adding a new paragraph 11-b which describes the conditions
under which every policy that provides coverage for hospital, surgical
or medical care shall provide coverage for ovarian cancer screening.
Section II amends subsection (1) of section 3221 of the insurance law is
amended by adding a new paragraph 11-b to provide a list of ovarian
cancer screening procedures to be covered by every insurer delivering a
group or blanket policy or issuing a group or blanket policy for deliv-
ery in this state that provides coverage for hospital, surgical or
medical care.
Section III amends section 4303 of the insurance law by adding a new
subsection (p-1) to provide a list of ovarian cancer screening proce-
dures to be covered by a medical expense indemnity corporation, a hospi-
tal service corporation or a health service corporation that provides
coverage for hospital, surgical or medical care.
Section IV sets forth the effective date.
JUSTIFICATION:
This legislation would help prevent insurance companies from discrimi-
nating against people who have high predispositions to cancer. It would
cover the costs of ovarian cancer screening which could lead to early
detection and in some cases prevention of life-threatening cancer.
According to the American Cancer Society, approximately 22,240 women
will be diagnosed with ovarian cancer in 2013 in the United States and
14,020 will lose their battle with ovarian cancer. The cause ovarian
cancer remains unknown; however, it is proven that individuals can lower
their risks by making certain lifestyle changes. There are also many
factors that contribute to ovarian cancer that are uncontrollable such
as age, race, ethnicity, family history and reproductive history. These
characteristics cannot be modified and therefore are important tools in
detecting these signs early include cancer screenings which will lead to
early detection and in most cases successful treatment options. This
bill would require insurance companies to include cancer screenings in
their policies and save many lives by detecting and treating cancer
early.
LEGISLATIVE HISTORY:
2018: A01182 (Rozic) - Insurance 2017: A01182 (Rozic) - Insurance
2016: A00323 (Rozic) - Insurance 2015: A00323 (Rozic) - Insurance
2014: A08473 (Rozic) - Insurance 2013: A3760A (Espinal) - Insurance
2012: A10526 (Espinal) - Insurance
FISCAL IMPACT ON THE STATE:
None.
EFFECTIVE DATE:
This act shall take effect on the sixtieth day after it shall have
become law.
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.
