S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  1392

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             January 7, 2011
                               ___________

Introduced  by Sens. PERKINS, DUANE, HASSELL-THOMPSON, KRUEGER, MONTGOM-
  ERY, PARKER, SAMPSON, SERRANO, SMITH, STAVISKY, VALESKY -- read  twice
  and ordered printed, and when printed to be committed to the Committee
  on Insurance

AN  ACT  to amend the insurance law, in relation to providing for health
  insurance coverage for diagnostic screening for colorectal cancer

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Subsection  (i)  of  section 3216 of the insurance law is
amended by adding a new paragraph 11-b to read as follows:
  (11-B) (A) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE
WHICH PROVIDES MEDICAL COVERAGE THAT  INCLUDES  COVERAGE  FOR  PHYSICIAN
SERVICES  IN  A PHYSICIAN'S OFFICE AND EVERY POLICY WHICH PROVIDES MAJOR
MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE,  UPON  THE
PRESCRIPTION  OF  A HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE
UNDER TITLE EIGHT OF THE EDUCATION LAW, THE FOLLOWING COVERAGE FOR DIAG-
NOSTIC SCREENING FOR COLORECTAL CANCER:
  (I) STANDARD DIAGNOSTIC TESTING  INCLUDING,  BUT  NOT  LIMITED  TO,  A
DIGITAL RECTAL EXAMINATION AT ANY AGE FOR PEOPLE HAVING A FAMILY HISTORY
OF  COLORECTAL  CANCER  OR  A PERSONAL HISTORY OF POLYPS OR INFLAMMATORY
BOWEL DISEASE; AND
  (II) AN ANNUAL STANDARD  DIAGNOSTIC  EXAMINATION  INCLUDING,  BUT  NOT
LIMITED  TO,  A DIGITAL RECTAL EXAMINATION FOR PEOPLE AGE FIFTY AND OVER
WHO ARE ASYMPTOMATIC AND FOR PEOPLE AGE FORTY AND  OVER  WITH  A  FAMILY
HISTORY OF COLORECTAL CANCER OR OTHER COLORECTAL CANCER RISK FACTORS.
  (B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
  S 2. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 11-b to read as follows:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05361-01-1

              

S. 1392                             2

  (11-B) (A) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE
WHICH  PROVIDES  MEDICAL  COVERAGE  THAT INCLUDES COVERAGE FOR PHYSICIAN
SERVICES IN A PHYSICIAN'S OFFICE AND EVERY POLICY WHICH  PROVIDES  MAJOR
MEDICAL  OR  SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE, UPON THE
PRESCRIPTION  OF  A HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE
UNDER TITLE EIGHT OF THE EDUCATION LAW, THE FOLLOWING COVERAGE FOR DIAG-
NOSTIC SCREENING FOR COLORECTAL CANCER:
  (I) STANDARD DIAGNOSTIC TESTING  INCLUDING,  BUT  NOT  LIMITED  TO,  A
DIGITAL RECTAL EXAMINATION AT ANY AGE FOR PEOPLE HAVING A FAMILY HISTORY
OF  COLORECTAL  CANCER  OR  A PERSONAL HISTORY OF POLYPS OR INFLAMMATORY
BOWEL DISEASE; AND
  (II) AN ANNUAL STANDARD  DIAGNOSTIC  EXAMINATION  INCLUDING,  BUT  NOT
LIMITED  TO,  A DIGITAL RECTAL EXAMINATION FOR PEOPLE AGE FIFTY AND OVER
WHO ARE ASYMPTOMATIC AND FOR PEOPLE AGE FORTY AND  OVER  WITH  A  FAMILY
HISTORY OF COLORECTAL CANCER OR OTHER COLORECTAL CANCER RISK FACTORS.
  (B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
  S  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (z-2) to read as follows:
  (Z-2) (1) EVERY POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS  STATE
WHICH  PROVIDES  MEDICAL  COVERAGE  THAT INCLUDES COVERAGE FOR PHYSICIAN
SERVICES IN A PHYSICIAN'S OFFICE AND EVERY POLICY WHICH  PROVIDES  MAJOR
MEDICAL  OR  SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE, UPON THE
PRESCRIPTION OF A HEALTH CARE PROVIDER LEGALLY AUTHORIZED  TO  PRESCRIBE
UNDER TITLE EIGHT OF THE EDUCATION LAW, THE FOLLOWING COVERAGE FOR DIAG-
NOSTIC SCREENING FOR COLORECTAL CANCER:
  (A)  STANDARD  DIAGNOSTIC  TESTING  INCLUDING,  BUT  NOT LIMITED TO, A
DIGITAL RECTAL EXAMINATION AT ANY AGE FOR PEOPLE HAVING A FAMILY HISTORY
OF COLORECTAL CANCER OR A PERSONAL HISTORY  OF  POLYPS  OR  INFLAMMATORY
BOWEL DISEASE; AND
  (B)  AN  ANNUAL  STANDARD  DIAGNOSTIC  EXAMINATION  INCLUDING, BUT NOT
LIMITED TO, A DIGITAL RECTAL EXAMINATION FOR PEOPLE AGE FIFTY  AND  OVER
WHO  ARE  ASYMPTOMATIC  AND  FOR PEOPLE AGE FORTY AND OVER WITH A FAMILY
HISTORY OF COLORECTAL CANCER OR OTHER COLORECTAL CANCER RISK FACTORS.
  (2) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
  S 4. This act shall take effect on the first of January next  succeed-
ing the date on which it shall have become a law.