Bill Text: NY A04238 | 2013-2014 | General Assembly | Introduced

---

Bill Title: Provides that every health insurance policy which provides coverage for hospital, surgical or medical care shall provide coverage for the standard diagnostic testing for ovarian cancer upon the recommendation of a physician; provides that such standard diagnostic testing shall include a pelvic examination, a sonogram and a CA 125 blood test and related laboratory and diagnostic services.

Spectrum: Partisan Bill (Democrat 20-0)

Status: (Introduced - Dead) 2014-01-08 - referred to insurance [A04238 Detail]

Download: New_York-2013-A04238-Introduced.html

---

                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         4238
                              2013-2014 Regular Sessions
                                 I N  A S S E M B L Y
                                   February 1, 2013
                                      ___________
       Introduced by M. of A. PRETLOW, JAFFEE -- Multi-Sponsored by -- M. of A.
         CAHILL,  CLARK,  COOK, CUSICK, DINOWITZ, GALEF, GLICK, HOOPER, JACOBS,
         V. LOPEZ, MAGEE, MILLMAN, ORTIZ, PERRY,  SCARBOROUGH,  SWEENEY,  WEIN-
         STEIN,  WEISENBERG,  WRIGHT -- read once and referred to the Committee
         on Insurance
       AN ACT to amend the insurance  law,  in  relation  to  health  insurance
         coverage for diagnostic testing for ovarian cancer
         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 DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE
    4  WHICH  PROVIDES  MEDICAL  COVERAGE  THAT INCLUDES COVERAGE FOR PHYSICIAN
    5  SERVICES IN A PHYSICIAN'S OFFICE AND EVERY POLICY WHICH  PROVIDES  MAJOR
    6  MEDICAL  OR  SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE, UPON THE
    7  PRESCRIPTION OF A HEALTH CARE PROVIDER LEGALLY AUTHORIZED  TO  PRESCRIBE
    8  UNDER  TITLE EIGHT OF THE EDUCATION LAW, COVERAGE FOR DIAGNOSTIC TESTING
    9  FOR OVARIAN CANCER, INCLUDING A PELVIC EXAMINATION, A SONOGRAM, A CA 125
   10  BLOOD TEST AND LABORATORY AND DIAGNOSTIC SERVICES PROVIDED IN CONNECTION
   11  WITH EXAMINING AND EVALUATING SUCH BLOOD TEST FOR WOMEN AGED  FORTY  AND
   12  OVER  WITH  ONE OR MORE FEMALE RELATIVES WITH A PRIOR HISTORY OF OVARIAN
   13  CANCER.
   14    (B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
   15  AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
   16  WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
   17    S 2. Subsection (l) of section 3221 of the insurance law is amended by
   18  adding a new paragraph 11-b to read as follows:
   19    (11-B) (A) EVERY INSURER WHICH DELIVERS OR ISSUES FOR DELIVERY IN THIS
   20  STATE A POLICY WHICH PROVIDES MEDICAL COVERAGE  THAT  INCLUDES  COVERAGE
   21  FOR PHYSICIAN SERVICES IN A PHYSICIAN'S OFFICE OR MAJOR MEDICAL OR SIMI-
   22  LAR  COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE, UPON THE PRESCRIPTION OF
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD07577-01-3
       A. 4238                             2
    1  A HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT
    2  OF THE EDUCATION  LAW,  COVERAGE  FOR  DIAGNOSTIC  TESTING  FOR  OVARIAN
    3  CANCER,  INCLUDING A PELVIC EXAMINATION, A SONOGRAM, A CA 125 BLOOD TEST
    4  AND LABORATORY AND DIAGNOSTIC SERVICES PROVIDED IN CONNECTION WITH EXAM-
    5  INING  AND EVALUATING SUCH BLOOD TEST FOR WOMEN AGED FORTY AND OVER WITH
    6  ONE OR MORE FEMALE RELATIVES WITH A PRIOR HISTORY OF OVARIAN CANCER.
    7    (B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
    8  AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
    9  WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
   10    S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
   11  subsection (jj) to read as follows:
   12    (JJ)  (1)  A  HOSPITAL  SERVICE CORPORATION, MEDICAL EXPENSE INDEMNITY
   13  CORPORATION OR HEALTH SERVICE CORPORATION WHICH PROVIDES MEDICAL  COVER-
   14  AGE  THAT  INCLUDES  COVERAGE  FOR  PHYSICIAN  SERVICES IN A PHYSICIAN'S
   15  OFFICE OR MAJOR MEDICAL OR  SIMILAR  COMPREHENSIVE-TYPE  COVERAGE  SHALL
   16  PROVIDE, UPON THE PRESCRIPTION OF A HEALTH CARE PROVIDER LEGALLY AUTHOR-
   17  IZED  TO  PRESCRIBE UNDER TITLE EIGHT OF THE EDUCATION LAW, COVERAGE FOR
   18  DIAGNOSTIC TESTING FOR OVARIAN CANCER, INCLUDING A PELVIC EXAMINATION, A
   19  SONOGRAM, A CA 125 BLOOD TEST AND  LABORATORY  AND  DIAGNOSTIC  SERVICES
   20  PROVIDED IN CONNECTION WITH EXAMINING AND EVALUATING SUCH BLOOD TEST FOR
   21  WOMEN AGED FORTY AND OVER WITH ONE OR MORE FEMALE RELATIVES WITH A PRIOR
   22  HISTORY OF OVARIAN CANCER.
   23    (2) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
   24  AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
   25  WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
   26    S  4. This act shall take effect on the first of January next succeed-
   27  ing the date on which it shall have become a law and shall apply to  all
   28  policies issued, renewed, altered or modified on or after such effective
   29  date.