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S00824 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                           824
 
                               2023-2024 Regular Sessions
 
                    IN SENATE
 
                                     January 6, 2023
                                       ___________
 
        Introduced  by  Sen. SANDERS -- read twice and ordered printed, and when
          printed to be committed to the Committee on Rules
 
        AN ACT to amend the insurance law and a chapter  of  the  laws  of  2022
          relating  to  providing insurance coverage for colorectal cancer early
          detection, as proposed in legislative bills numbers S.  906-B  and  A.
          2085-A,  in  relation to coverage for preventive screenings and notice
          requirements; and to repeal certain provisions of  the  insurance  law
          and of such chapter relating thereto
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Paragraph 11-b of subsection (i) of  section  3216  of  the
     2  insurance  law,  as  added by a chapter of the laws of 2022 amending the
     3  insurance  law  relating to providing insurance  coverage for colorectal
     4  cancer early detection, as proposed in legislative bills numbers S.906-B
     5  and A. 2085-A, is REPEALED.
     6    § 2. Paragraph 11-b of subsection (l) of section 3221 of the insurance
     7  law, as added by a chapter of the laws of 2022  amending  the  insurance
     8  law  relating  to  providing  insurance   coverage for colorectal cancer
     9  early detection, as proposed in legislative bills numbers S.906-B and A.
    10  2085-A,  is amended to read as follows:
    11    (11-b) (A) Every large group policy delivered or issued  for  delivery
    12  in this state which provides medical coverage that includes coverage for
    13  physician  services in a physician's office and every large group policy
    14  which provides major  medical  or  similar  comprehensive-type  coverage
    15  shall  provide, upon the prescription of a health care provider [legally
    16  authorized to prescribe under] acting within  the  provider's  scope  of
    17  practice  pursuant  to  title  eight  of the education law, coverage for
    18  colorectal cancer [screening] preventive screenings in  accordance  with
    19  the  American  Cancer Society Guidelines for colorectal cancer screening
    20  of average risk individuals. The coverage  required  by  this  paragraph
    21  shall also include [preventive colorectal cancer screening] coverage for
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04015-01-3

        S. 824                              2
 
     1  all  additional  colorectal  cancer  examinations  and  laboratory tests
     2  recommended in accordance with the American  Cancer  Society  Guidelines
     3  for  colorectal  cancer screening of average risk individuals, including
     4  an initial colonoscopy or other medical test or procedure for colorectal
     5  cancer  screening and a follow-up colonoscopy performed as a result of a
     6  positive result on a non-colonoscopy preventive screening test. A  large
     7  group policy shall cover colorectal cancer screenings, examinations, and
     8  laboratory tests described in this paragraph upon any policy issuance or
     9  renewal that occurs six months after the date the guideline described in
    10  this paragraph is issued.
    11    (B)  An  [individual]  insured  shall  not be subject to a deductible,
    12  coinsurance,  or  any  other  cost-sharing  requirements  for   services
    13  consistent with subparagraph (A) of this paragraph received from partic-
    14  ipating providers.
    15    §  3.  Section  4303  of  the insurance law is amended by adding a new
    16  subsection (uu) to read as follows:
    17    (uu) (1) Every large group contract delivered or issued  for  delivery
    18  in this state which provides medical coverage that includes coverage for
    19  physician  services  in  a  physician's  office  and  every  large group
    20  contract which provides  major  medical  or  similar  comprehensive-type
    21  coverage  shall provide, upon the prescription of a health care provider
    22  acting within the provider's scope of practice pursuant to  title  eight
    23  of  the education law, coverage for colorectal cancer preventive screen-
    24  ings in accordance with the American Cancer Society Guidelines for colo-
    25  rectal cancer  screening  of  average  risk  individuals.  The  coverage
    26  required  by  this  subsection shall also include coverage for all addi-
    27  tional colorectal cancer examinations and laboratory  tests  recommended
    28  in accordance with the American Cancer Society Guidelines for colorectal
    29  cancer screening of average risk individuals, including an initial colo-
    30  noscopy or other medical test or procedure for colorectal cancer screen-
    31  ing  and  a  follow-up  colonoscopy  performed as a result of a positive
    32  result on a non-colonoscopy preventive screening  test.  A  large  group
    33  contract  shall  cover  colorectal  cancer screenings, examinations, and
    34  laboratory tests described in this subsection upon any contract issuance
    35  or renewal that occurs six months after the date the guideline described
    36  in this subsection is issued.
    37    (2) An enrollee shall not be subject to a deductible, coinsurance,  or
    38  any  other  cost-sharing requirements for services consistent with para-
    39  graph one of this subsection received from participating providers.
    40    § 4. Section 3 of a chapter of the laws of 2022 relating to  providing
    41  insurance coverage for colorectal cancer early detection, as proposed in
    42  legislative bills numbers S.906-B and A. 2085-A, is REPEALED.
    43    §  5. The insurance law is amended by adding a new section 339 to read
    44  as follows:
    45    § 339. Colorectal cancer screening  notification.  The  superintendent
    46  shall  require an insurer authorized to write accident and health insur-
    47  ance in this state, a corporation organized pursuant to  article  forty-
    48  three  of  this chapter, and a health maintenance organization certified
    49  pursuant to article forty-four  of  the  public  health  law  to  notify
    50  insureds and enrollees at least annually of colorectal cancer screenings
    51  covered  by  such  insureds'  or  enrollees'  health insurance policy or
    52  contract, and of the most recently published guidelines of the  American
    53  Cancer Society for colorectal cancer screenings that are covered by such
    54  insureds'  or enrollees' health insurance policy or contract. The notice
    55  shall be delivered by United States postal mail unless  the  insured  or

        S. 824                              3
 
     1  enrollee consents to another method of notification, including electron-
     2  ic notification.
     3    §  6. Section 4 of a chapter of the laws of 2022 relating to providing
     4  insurance coverage for colorectal cancer early detection, as proposed in
     5  legislative bills numbers S.906-B and A. 2085-A, is amended to  read  as
     6  follows:
     7    §  4.  This  act  shall take effect immediately and shall apply to any
     8  policy issued, [delivered,]  renewed,  [and/or]  modified,  altered,  or
     9  amended on or after the effective date of this act.
    10    §  7.  This  act shall take effect immediately; provided that sections
    11  one, two, three, four and five of this act shall take effect on the same
    12  date and in the same manner as of a chapter of the laws of 2022 relating
    13  to providing insurance coverage for colorectal cancer  early  detection,
    14  as  proposed  in  legislative bills numbers S.906-B and A. 2085-A, takes
    15  effect.
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