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

                                  4038

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                            January 30, 2013
                               ___________

Introduced  by M. of A. PRETLOW -- read once and referred to the Commit-
  tee on Insurance

AN ACT to amend the insurance law, in relation to requiring coverage for
  genetic testing in accident and health insurance policies

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

  Section  1.  Section  3216 of the insurance law is amended by adding a
new subsection (m) to read as follows:
  (M) (1) (A) FOR PURPOSES OF  THIS  SUBSECTION:  "PREDISPOSING  GENETIC
CHARACTERISTIC"  SHALL  MEAN ANY INHERITED GENE OR CHROMOSOME, OR ALTER-
ATION THEREOF, AND DETERMINED BY A GENETIC TEST OR INFERRED FROM  INFOR-
MATION  DERIVED  FROM  AN  INDIVIDUAL OR FAMILY MEMBER THAT IS SCIENTIF-
ICALLY  OR  MEDICALLY  BELIEVED  TO  PREDISPOSE  AN  INDIVIDUAL  OR  THE
OFFSPRING  OF THAT INDIVIDUAL TO A DISEASE OR DISABILITY, OR TO BE ASSO-
CIATED WITH A STATISTICALLY SIGNIFICANT INCREASED RISK OF  THE  DEVELOP-
MENT OF A PHYSICAL OR MENTAL DISEASE OR DISABILITY; AND
  (B)  "GENETIC  TESTING" SHALL MEAN A TEST FOR DETERMINING THE PRESENCE
OR ABSENCE OF AN INHERITED  GENETIC  CHARACTERISTIC  IN  AN  INDIVIDUAL,
INCLUDING TESTS OF NUCLEIC ACIDS SUCH AS DNA, RNA AND MITOCHONDRIAL DNA,
CHROMOSOMES  OR  PROTEINS  IN  ORDER  TO IDENTIFY A PREDISPOSING GENETIC
CHARACTERISTIC.
  (2) ON AND AFTER SEPTEMBER FIRST, TWO THOUSAND THIRTEEN  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 COMPRE-
HENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR  GENETIC  TESTING,  AND
ANY  SUBSEQUENT  TREATMENT  RESULTING  FROM THE RESULTS OF SUCH TEST, OF
PERSONS WHO, IN THE OPINION OF AN ATTENDING PHYSICIAN ARE PERSONS WITH A
SIGNIFICANT RISK OF CONTRACTING CANCER. FOR PURPOSES OF THIS SECTION,  A
PERSON  SHALL  BE DEEMED TO HAVE A SIGNIFICANT RISK IF THERE IS A FAMILY
HISTORY OF CANCER, MORE THAN ONE  GENERATION  IN  SUCH  FAMILY  HAS  HAD

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD07567-01-3
              

A. 4038                             2

CANCER,  A FAMILY MEMBER HAS HAD MORE THAN ONE OCCURRENCE OF CANCER OR A
FAMILY MEMBER LESS THAN FORTY-FIVE YEARS OF AGE HAS BEEN DIAGNOSED  WITH
CANCER.  NOTHING  IN  THIS  SUBSECTION  SHALL  BE DEEMED TO AUTHORIZE AN
INSURER  TO  UTILIZE  OR  RELEASE THE RESULTS OF SUCH TEST FOR ANY OTHER
PURPOSE. NO POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE PURSU-
ANT TO THIS ARTICLE, SHALL BE DENIED OR CANCELLED  ON  THE  BASIS  OF  A
PREDISPOSING GENETIC CHARACTERISTIC.
  S 2. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 11-b to read as follows:
  (11-B)  (A)  (I) FOR PURPOSES OF THIS PARAGRAPH: "PREDISPOSING GENETIC
CHARACTERISTIC" SHALL MEAN ANY INHERITED GENE OR CHROMOSOME,  OR  ALTER-
ATION  THEREOF, AND DETERMINED BY A GENETIC TEST OR INFERRED FROM INFOR-
MATION DERIVED FROM AN INDIVIDUAL OR FAMILY  MEMBER  THAT  IS  SCIENTIF-
ICALLY  OR  MEDICALLY  BELIEVED  TO  PREDISPOSE  AN  INDIVIDUAL  OR  THE
OFFSPRING OF THAT INDIVIDUAL TO A DISEASE OR DISABILITY, OR TO BE  ASSO-
CIATED  WITH  A STATISTICALLY SIGNIFICANT INCREASED RISK OF THE DEVELOP-
MENT OF A PHYSICAL OR MENTAL DISEASE OR DISABILITY; AND
  (II) "GENETIC TESTING" SHALL MEAN A TEST FOR DETERMINING THE  PRESENCE
OR  ABSENCE  OF  AN  INHERITED  GENETIC CHARACTERISTIC IN AN INDIVIDUAL,
INCLUDING TESTS OF NUCLEIC ACIDS SUCH AS DNA, RNA AND MITOCHONDRIAL DNA,
CHROMOSOMES OR PROTEINS IN ORDER  TO  IDENTIFY  A  PREDISPOSING  GENETIC
CHARACTERISTIC.
  (B)  ON  AND AFTER SEPTEMBER FIRST, TWO THOUSAND THIRTEEN 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 MAJOR MEDICAL OR SIMILAR  COMPREHENSIVE-TYPE  COVERAGE  SHALL
PROVIDE  COVERAGE  FOR  GENETIC  TESTING,  AND  ANY SUBSEQUENT TREATMENT
RESULTING FROM THE RESULTS OF SUCH TEST, OF PERSONS WHO, IN THE  OPINION
OF  AN  ATTENDING  PHYSICIAN  ARE  PERSONS  WITH  A  SIGNIFICANT RISK OF
CONTRACTING CANCER. FOR PURPOSES OF THIS  SECTION,  A  PERSON  SHALL  BE
DEEMED  TO  HAVE  A  SIGNIFICANT  RISK  IF  THERE IS A FAMILY HISTORY OF
CANCER, MORE THAN ONE GENERATION IN SUCH FAMILY HAS HAD CANCER, A FAMILY
MEMBER HAS HAD MORE THAN ONE OCCURRENCE OF CANCER  OR  A  FAMILY  MEMBER
LESS  THAN FORTY-FIVE YEARS OF AGE HAS BEEN DIAGNOSED WITH CANCER. NOTH-
ING IN THIS PARAGRAPH SHALL BE DEEMED TO AUTHORIZE AN INSURER TO UTILIZE
OR RELEASE THE RESULTS OF SUCH TEST FOR ANY  OTHER  PURPOSE.  NO  POLICY
DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE PURSUANT TO THIS ARTICLE,
SHALL  BE  DENIED  OR  CANCELLED  ON THE BASIS OF A PREDISPOSING GENETIC
CHARACTERISTIC.
  S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (jj) to read as follows:
  (JJ)  (1)  (A)  FOR PURPOSES OF THIS SUBSECTION: "PREDISPOSING GENETIC
CHARACTERISTIC" SHALL MEAN ANY INHERITED GENE OR CHROMOSOME,  OR  ALTER-
ATION  THEREOF, AND DETERMINED BY A GENETIC TEST OR INFERRED FROM INFOR-
MATION DERIVED FROM AN INDIVIDUAL OR FAMILY  MEMBER  THAT  IS  SCIENTIF-
ICALLY  OR  MEDICALLY  BELIEVED  TO  PREDISPOSE  AN  INDIVIDUAL  OR  THE
OFFSPRING OF THAT INDIVIDUAL TO A DISEASE OR DISABILITY, OR TO BE  ASSO-
CIATED  WITH  A STATISTICALLY SIGNIFICANT INCREASED RISK OF THE DEVELOP-
MENT OF A PHYSICAL OR MENTAL DISEASE OR DISABILITY; AND
  (B) "GENETIC TESTING" SHALL MEAN A TEST FOR DETERMINING  THE  PRESENCE
OR  ABSENCE  OF  AN  INHERITED  GENETIC CHARACTERISTIC IN AN INDIVIDUAL,
INCLUDING TESTS OF NUCLEIC ACIDS SUCH AS DNA, RNA AND MITOCHONDRIAL DNA,
CHROMOSOMES OR PROTEINS IN ORDER  TO  IDENTIFY  A  PREDISPOSING  GENETIC
CHARACTERISTIC.
  (2)  ON  AND AFTER SEPTEMBER FIRST, TWO THOUSAND THIRTEEN EVERY POLICY
DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE  WHICH  PROVIDES  MEDICAL

A. 4038                             3

COVERAGE  THAT INCLUDES COVERAGE FOR PHYSICIAN SERVICES IN A PHYSICIAN'S
OFFICE OR MAJOR MEDICAL OR  SIMILAR  COMPREHENSIVE-TYPE  COVERAGE  SHALL
PROVIDE  COVERAGE  FOR  GENETIC  TESTING,  AND  ANY SUBSEQUENT TREATMENT
RESULTING  FROM THE RESULTS OF SUCH TEST, OF PERSONS WHO, IN THE OPINION
OF AN ATTENDING  PHYSICIAN  ARE  PERSONS  WITH  A  SIGNIFICANT  RISK  OF
CONTRACTING  CANCER.  FOR  PURPOSES  OF  THIS SECTION, A PERSON SHALL BE
DEEMED TO HAVE A SIGNIFICANT RISK  IF  THERE  IS  A  FAMILY  HISTORY  OF
CANCER, MORE THAN ONE GENERATION IN SUCH FAMILY HAS HAD CANCER, A FAMILY
MEMBER  HAS  HAD  MORE  THAN ONE OCCURRENCE OF CANCER OR A FAMILY MEMBER
LESS THAN FORTY-FIVE YEARS OF AGE HAS BEEN DIAGNOSED WITH CANCER.  NOTH-
ING  IN  THIS  SUBSECTION  SHALL  BE  DEEMED  TO AUTHORIZE AN INSURER TO
UTILIZE OR RELEASE THE RESULTS OF SUCH TEST FOR ANY  OTHER  PURPOSE.  NO
POLICY  DELIVERED  OR ISSUED FOR DELIVERY IN THIS STATE PURSUANT TO THIS
ARTICLE, SHALL BE DENIED OR CANCELLED ON THE  BASIS  OF  A  PREDISPOSING
GENETIC CHARACTERISTIC.
  S 4. This act shall take effect immediately.