Bill Text: NY A04463 | 2011-2012 | General Assembly | Introduced

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Bill Title: Provides insurance coverage for diagnostic screening for colorectal cancer determined by policyholder's physician and ancillary services.

Spectrum: Partisan Bill (Democrat 26-0)

Status: (Introduced - Dead) 2012-01-04 - referred to insurance [A04463 Detail]

Download: New_York-2011-A04463-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         4463
                              2011-2012 Regular Sessions
                                 I N  A S S E M B L Y
                                   February 3, 2011
                                      ___________
       Introduced  by  M.  of  A.  CYMBROWITZ, MAISEL, PHEFFER, COLTON, BARRON,
         CASTRO, GABRYSZAK, GALEF, GUNTHER, JAFFEE, REILLY,  ROBINSON,  TITONE,
         ZEBROWSKI,  BOYLAND,  CAHILL,  TITUS -- Multi-Sponsored by -- M. of A.
         BRENNAN, GLICK, GOTTFRIED, HOOPER, McENENY, MENG, SWEENEY,  WEINSTEIN,
         WEISENBERG -- read once and referred 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  (l)  of  section 3221 of the insurance law is
    2  amended by adding a new paragraph 12-a to read as follows:
    3    (12-A)(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, THE FOLLOWING COVERAGE FOR DIAG-
    9  NOSTIC SCREENING FOR COLORECTAL CANCER:
   10    (I) STANDARD DIAGNOSTIC TESTING INCLUDING, BUT NOT LIMITED TO, A COLO-
   11  NOSCOPY  AND  THE  MOST  RELIABLE,  MEDICALLY  RECOGNIZED SCREENING TEST
   12  AVAILABLE AT ANY AGE FOR ANY PERSON HAVING A PRIOR HISTORY OF COLORECTAL
   13  CANCER;
   14    (II) AN ANNUAL STANDARD  DIAGNOSTIC  EXAMINATION  INCLUDING,  BUT  NOT
   15  LIMITED  TO,  A  COLONOSCOPY  AND THE MOST RELIABLE MEDICALLY RECOGNIZED
   16  SCREENING TEST AVAILABLE FOR ANY PERSON AGE FIFTY AND OVER WHO IS ASYMP-
   17  TOMATIC AND FOR ANY PERSON AGE FORTY AND OVER WITH A FAMILY  HISTORY  OF
   18  COLORECTAL CANCER OR OTHER COLORECTAL CANCER RISK FACTORS; AND
   19    (III)  ANY  ANCILLARY SERVICE SUCH AS BUT NOT LIMITED TO PATHOLOGY AND
   20  ANESTHESIOLOGY  THAT  THE  POLICYHOLDER'S  PHYSICIAN  DETERMINES  TO  BE
   21  MEDICALLY NECESSARY AND APPROPRIATE.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD07853-01-1
       A. 4463                             2
    1    (B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
    2  AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
    3  WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
    4    S 2. Subsection (i) of section 3216 of the insurance law is amended by
    5  adding a new paragraph 28 to read as follows:
    6    (28)(A)  EVERY  POLICY  DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE
    7  WHICH PROVIDES MEDICAL COVERAGE THAT  INCLUDES  COVERAGE  FOR  PHYSICIAN
    8  SERVICES  IN  A PHYSICIAN'S OFFICE AND EVERY POLICY WHICH PROVIDES MAJOR
    9  MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE,  UPON  THE
   10  PRESCRIPTION  OF  A HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE
   11  UNDER TITLE EIGHT OF THE EDUCATION LAW, THE FOLLOWING COVERAGE FOR DIAG-
   12  NOSTIC SCREENING FOR COLORECTAL CANCER:
   13    (I) STANDARD DIAGNOSTIC TESTING INCLUDING, BUT NOT LIMITED TO, A COLO-
   14  NOSCOPY AND THE  MOST  RELIABLE,  MEDICALLY  RECOGNIZED  SCREENING  TEST
   15  AVAILABLE AT ANY AGE FOR ANY PERSON HAVING A PRIOR HISTORY OF COLORECTAL
   16  CANCER;
   17    (II)  AN  ANNUAL  STANDARD  DIAGNOSTIC  EXAMINATION INCLUDING, BUT NOT
   18  LIMITED TO, A COLONOSCOPY AND THE  MOST  RELIABLE  MEDICALLY  RECOGNIZED
   19  SCREENING TEST AVAILABLE FOR ANY PERSON AGE FIFTY AND OVER WHO IS ASYMP-
   20  TOMATIC  AND  FOR ANY PERSON AGE FORTY AND OVER WITH A FAMILY HISTORY OF
   21  COLORECTAL CANCER OR OTHER COLORECTAL CANCER RISK FACTORS; AND
   22    (III) ANY ANCILLARY SERVICE SUCH AS BUT NOT LIMITED TO  PATHOLOGY  AND
   23  ANESTHESIOLOGY  THAT  THE  POLICYHOLDER'S  PHYSICIAN  DETERMINES  TO  BE
   24  MEDICALLY NECESSARY AND APPROPRIATE.
   25    (B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
   26  AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
   27  WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
   28    S 3. This act shall take effect on the first of January next  succeed-
   29  ing  the date on which it shall have become a law and shall apply to all
   30  policies of life, accident and health insurance issued after such date.