Bill Text: NY A06140 | 2009-2010 | General Assembly | Introduced

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Bill Title: An act to amend the insurance law, in relation to providing insurance coverage for colorectal cancer early detection

Spectrum: Moderate Partisan Bill (Democrat 26-3)

Status: (Introduced - Dead) 2010-01-06 - referred to insurance [A06140 Detail]

Download: New_York-2009-A06140-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         6140
                              2009-2010 Regular Sessions
                                 I N  A S S E M B L Y
                                   February 26, 2009
                                      ___________
       Introduced  by  M.  of  A.  DINOWITZ,  CLARK,  V. LOPEZ, GALEF, MILLMAN,
         CUSICK, CYMBROWITZ, McENENY, ZEBROWSKI, ORTIZ, ENGLEBRIGHT, BRADLEY --
         Multi-Sponsored by -- M. of A. ALFANO, BARRA, BING, BRENNAN,  BRODSKY,
         CAHILL,  CANESTRARI,  CHRISTENSEN,  COLTON,  COOK,  GLICK,  GOTTFRIED,
         GREENE, JACOBS, PHEFFER, POWELL, RAIA, SCARBOROUGH, 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 (i) of section 3216  of  the  insurance  law  is
    2  amended by adding a new paragraph 26 to read as follows:
    3    (26) (A) EVERY POLICY WHICH PROVIDES COVERAGE PURSUANT TO THIS SECTION
    4  SHALL  PROVIDE  COVERAGE TO ANY NAMED SUBSCRIBER OR OTHER PERSON COVERED
    5  THEREUNDER FOR EXPENSES INCURRED IN CONDUCTING COLORECTAL  CANCER  EXAM-
    6  INATIONS  AND  LABORATORY TESTS AT REGULAR INTERVALS, INCLUDING EXPENSES
    7  INCURRED IN CONDUCTING PHYSICIAN  CONSULTATIONS  FOR  COLORECTAL  CANCER
    8  PRIOR  TO SUCH EXAMINATIONS AND TESTS, FOR PERSONS FIFTY YEARS OF AGE OR
    9  OLDER AND FOR PERSONS OF ANY AGE WHO ARE CONSIDERED TO BE AT  HIGH  RISK
   10  FOR COLORECTAL CANCER. THE METHODS OF SCREENING FOR WHICH BENEFITS SHALL
   11  BE PROVIDED SHALL INCLUDE BUT NOT BE LIMITED TO:
   12    (I) A SCREENING FECAL OCCULT BLOOD TEST;
   13    (II) FLEXIBLE SIGMOIDOSCOPY;
   14    (III) COLONOSCOPY;
   15    (IV) BARIUM ENEMA; OR
   16    (V)  THE MOST RELIABLE, MEDICALLY RECOGNIZED SCREENING TEST AVAILABLE;
   17  AND
   18    (VI) ANY COMBINATION THEREOF.
   19    THE METHOD AND FREQUENCY OF SCREENING  TO  BE  UTILIZED  SHALL  BE  IN
   20  ACCORD  WITH  THE  MOST  RECENTLY  PUBLISHED  GUIDELINES OF THE AMERICAN
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD02732-01-9
       A. 6140                             2
    1  COLLEGE OF GASTROENTEROLOGY OR THE AMERICAN GASTROENTEROLOGICAL  ASSOCI-
    2  ATION IN CONSULTATION WITH THE AMERICAN CANCER SOCIETY.
    3    (B) AS USED IN THIS PARAGRAPH, "HIGH RISK FOR COLORECTAL CANCER" SHALL
    4  MEAN A PERSON HAS,
    5    (I)  A  FAMILY  HISTORY  OF FAMILIAL ADENOMATOUS POLYPOSIS; HEREDITARY
    6  NON-POLYPOSIS COLON CANCER; OR BREAST,  OVARIAN,  ENDOMETRIAL  OR  COLON
    7  CANCER OR POLYPS;
    8    (II) CHRONIC INFLAMMATORY BOWEL DISEASE; OR
    9    (III) A BACKGROUND, ETHNICITY OR LIFESTYLE THAT THE PHYSICIAN BELIEVES
   10  PUTS THE PERSON AT ELEVATED RISK FOR COLORECTAL CANCER.
   11    S 2. Subsection (k) of section 3221 of the insurance law is amended by
   12  adding a new paragraph 15 to read as follows:
   13    (15) (A) EVERY POLICY WHICH PROVIDES COVERAGE PURSUANT TO THIS SECTION
   14  SHALL  PROVIDE  COVERAGE TO ANY NAMED SUBSCRIBER OR OTHER PERSON COVERED
   15  THEREUNDER FOR EXPENSES INCURRED IN CONDUCTING COLORECTAL  CANCER  EXAM-
   16  INATIONS  AND  LABORATORY TESTS AT REGULAR INTERVALS, INCLUDING EXPENSES
   17  INCURRED IN CONDUCTING PHYSICIAN  CONSULTATIONS  FOR  COLORECTAL  CANCER
   18  PRIOR  TO SUCH EXAMINATIONS AND TESTS, FOR PERSONS FIFTY YEARS OF AGE OR
   19  OLDER AND FOR PERSONS OF ANY AGE WHO ARE CONSIDERED TO BE AT  HIGH  RISK
   20  FOR COLORECTAL CANCER. THE METHODS OF SCREENING FOR WHICH BENEFITS SHALL
   21  BE PROVIDED SHALL INCLUDE BUT NOT BE LIMITED TO:
   22    (I) A SCREENING FECAL OCCULT BLOOD TEST;
   23    (II) FLEXIBLE SIGMOIDOSCOPY;
   24    (III) COLONOSCOPY;
   25    (IV) BARIUM ENEMA; OR
   26    (V)  THE MOST RELIABLE, MEDICALLY RECOGNIZED SCREENING TEST AVAILABLE;
   27  AND
   28    (VI) ANY COMBINATION THEREOF.
   29    THE METHOD AND FREQUENCY OF SCREENING  TO  BE  UTILIZED  SHALL  BE  IN
   30  ACCORD  WITH  THE  MOST  RECENTLY  PUBLISHED  GUIDELINES OF THE AMERICAN
   31  COLLEGE OF GASTROENTEROLOGY OR THE AMERICAN GASTROENTEROLOGICAL  ASSOCI-
   32  ATION IN CONSULTATION WITH THE AMERICAN CANCER SOCIETY.
   33    (B) AS USED IN THIS PARAGRAPH, "HIGH RISK FOR COLORECTAL CANCER" SHALL
   34  MEAN A PERSON HAS,
   35    (I)  A  FAMILY  HISTORY  OF FAMILIAL ADENOMATOUS POLYPOSIS; HEREDITARY
   36  NON-POLYPOSIS COLON CANCER; OR BREAST,  OVARIAN,  ENDOMETRIAL  OR  COLON
   37  CANCER OR POLYPS;
   38    (II) CHRONIC INFLAMMATORY BOWEL DISEASE; OR
   39    (III) A BACKGROUND, ETHNICITY OR LIFESTYLE THAT THE PHYSICIAN BELIEVES
   40  PUTS THE PERSON AT ELEVATED RISK FOR COLORECTAL CANCER.
   41    S 3. Subsection (a) of section 4303 of the insurance law is amended by
   42  adding a new paragraph 4 to read as follows:
   43    (4) TO PERSONS FIFTY YEARS OF AGE OR OLDER FOR SERVICES RELATED TO THE
   44  CONDUCTING  OF  COLORECTAL  CANCER  EXAMINATIONS AND LABORATORY TESTS AT
   45  REGULAR INTERVALS, INCLUDING EXPENSES INCURRED IN  CONDUCTING  PHYSICIAN
   46  CONSULTATIONS  FOR  COLORECTAL  CANCER  PRIOR  TO  SUCH EXAMINATIONS AND
   47  TESTS, INCLUDING BUT NOT LIMITED TO, COLONOSCOPIES, COLOSCOPIES, SCREEN-
   48  ING FECAL OCCULT BLOOD TESTS, FLEXIBLE SIGMOIDOSCOPIES OR BARIUM ENEMAS.
   49    S 4. The superintendent of insurance shall require an insurer,  health
   50  carrier  or health benefit plan to notify enrollees annually of colorec-
   51  tal cancer screenings covered by such enrollees' health benefit plan and
   52  the most recently  published  guidelines  of  the  American  College  of
   53  Gastroenterology  or  the  American  Gastroenterological  Association in
   54  consultation with the American  Cancer  Society  for  colorectal  cancer
   55  screenings  or  notify  enrollees  at intervals consistent with the most
   56  recently published guidelines of the American College of Gastroenterolo-
       A. 6140                             3
    1  gy or the American Gastroenterological Association in consultation  with
    2  the  American  Cancer  Society of colorectal cancer screenings which are
    3  covered by such enrollees' health benefit plans.   The notice  shall  be
    4  delivered  by mail unless the enrollee and health carrier have agreed on
    5  another method of  notification.  The  superintendent  of  insurance  is
    6  authorized  to  promulgate  necessary  rules  and  regulations  for  the
    7  purposes of providing such notification.
    8    S 5. This act shall take effect immediately and  shall  apply  to  any
    9  policy  issued,  delivered,  renewed,  and/or  modified  on or after the
   10  effective date of this act.