NY State Senate Bill 2015-S8093

Senate Bill S8093

Signed By Governor

2015-2016 Legislative Session

Relates to coverage for the detection of breast cancer, requiring certified mammography facilities to provide extended hours and excused leave to undertake a breast cancer screening

download bill text pdf

Archive: Last Bill Status - Signed by Governor

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jun 27, 2016	signed chap.74
Jun 24, 2016	delivered to governor
Jun 16, 2016	returned to senate passed assembly ordered to third reading rules cal.475 substituted for a10679 referred to codes delivered to assembly passed senate ordered to third reading cal.1884
Jun 12, 2016	referred to rules

Votes

- Jun 16, 2016 - Floor Vote
  S8093
  
  62
  
  Aye
  
  0
  
  Nay
  
  0
  
  Absent
  
  1
  
  Excused
  
  0
  
  Abstained
  - - Floor Vote: Jun 16, 2016
      
      aye (62)
      
      Addabbo Jr.
      
      Akshar
      
      Amedore
      
      Avella
      
      Bonacic
      
      Boyle
      
      Breslin
      
      Carlucci
      
      Comrie
      
      Croci
      
      DeFrancisco
      
      Dilan
      
      Espaillat
      
      Farley
      
      Felder
      
      Flanagan
      
      Funke
      
      Gallivan
      
      Gianaris
      
      Golden
      
      Griffo
      
      Hamilton
      
      Hannon
      
      Hassell-Thompson
      
      Hoylman-Sigal
      
      Kaminsky
      
      Kennedy
      
      Klein
      
      Krueger
      
      LaValle
      
      Lanza
      
      Larkin
      
      Latimer
      
      Little
      
      Marcellino
      
      Marchione
      
      Martins
      
      Montgomery
      
      Murphy
      
      Nozzolio
      
      O'Mara
      
      Ortt
      
      Panepinto
      
      Parker
      
      Peralta
      
      Perkins
      
      Persaud
      
      Ranzenhofer
      
      Ritchie
      
      Rivera
      
      Robach
      
      Sanders Jr.
      
      Savino
      
      Serino
      
      Serrano
      
      Seward
      
      Squadron
      
      Stavisky
      
      Stewart-Cousins
      
      Valesky
      
      Venditto
      
      Young
      
      excused (1)
      
      Diaz
  Jun 16, 2016 - Rules Committee Vote
  S8093
  
  25
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Rules Committee Vote: Jun 16, 2016
      
      aye (25)
      
      Bonacic
      
      Breslin
      
      Carlucci
      
      DeFrancisco
      
      Dilan
      
      Espaillat
      
      Farley
      
      Flanagan
      
      Gianaris
      
      Hannon
      
      Hassell-Thompson
      
      Krueger
      
      LaValle
      
      Lanza
      
      Larkin
      
      Little
      
      Marcellino
      
      Montgomery
      
      Nozzolio
      
      Parker
      
      Perkins
      
      Robach
      
      Seward
      
      Stewart-Cousins
      
      Valesky

co-Sponsors

View additional co-sponsors

2015-S8093 (ACTIVE) - Details

See Assembly Version of this Bill:: A10679
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L; add §2404-d, Pub Health L; amd §159-b, Civ Serv L

2015-S8093 (ACTIVE) - Summary

Relates to coverage for the detection of breast cancer; requires certified mammography facilities to provide extended hours; allows certain public employees excused leave to undertake a breast cancer screening.

2015-S8093 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S8093

 TITLE OF BILL :

An act to amend the insurance law, in relation to coverage for the
detection of breast cancer; to amend the public health law, in
relation to requiring certified mammography facilities to provide
extended hours; and to amend the civil service law, in relation to
excused leave to undertake a screening for breast cancer

 PURPOSE :

In order to facilitate early detection and treatment of breast cancer,
this bill would amend: (i) the Insurance Law to prohibit deductibles,
co-payments, and coinsurance (collectively "cost-sharing") for
mammograms and other screening and diagnostic imaging; (ii) the Public
Health Law to require certified mammography facilities to provide
extended hours; and (iii) the Civil Service Law to allow New York City
public employees up to four hours of paid leave annually for breast
cancer screenings.

 SUMMARY OF PROVISIONS :

Sections 1, 2, and 3 of the bill would amend Ins. L. § 3216 to
prohibit cost-sharing in individual commercial policies:

*Section 1 would amend Ins. L. § 3216 (i)(11)(B) to prohibit
cost-sharing for mammography screening for breast cancer in any policy
that provides hospital, surgical or medical care coverage.

*Section 2 would add a new subparagraph (F) to Ins. L. § 3216 (i)(11)
to prohibit cost-sharing for screening and diagnostic imaging for the
detection of breast cancer, including diagnostic mammograms, breast
ultrasounds, or magnetic resonance imaging otherwise covered under the
policy.

*Section 3 would add a new paragraph 33 to Ins. L. § 3216(i) to
specify that provisions requiring an insurer to provide benefits
without cost-sharing apply only to: (i) participating providers in the
insurer's network; and (ii) in cases where the insurer does not have
an in-network participating provider with the appropriate training and
experience to meet the health care needs of the insured,
non-participating providers.

Sections 4, 5, and 6 of the bill would amend Ins. L. § 3221 to
prohibit cost-sharing in blanket or commercial policies:

*Section 4 would amend Ins. L. § 3221(1)(11)(B) to prohibit
cost-sharing for mammography screening for breast cancer in any policy
that provides hospital, surgical or medical care coverage.

*Section 5 would add a new subparagraph (F) to Ins. L. § 3221(1)(11)
to prohibit cost-sharing for screening and diagnostic imaging for the
detection of breast cancer, including diagnostic mammograms, breast
ultrasounds, or magnetic resonance imaging, covered under the policy.

*Section 6 of the bill would add a new paragraph 19 to Ins. L. §
3221(1) to specify that provisions requiring an insurer to provide
benefits without cost-sharing apply only to: (i) participating
providers in the insurer's network; and (ii) in cases where the
insurer does not have an in-network participating provider with the
appropriate training and experience to meet the health care needs of
the insured, non-participating providers.



Sections 7, 8, and 9 of the bill would amend Ins. L. § 4303 to
prohibit cost-sharing in coverage provided by health maintenance
organizations and Article 43 corporations:

*Section 7 would amend Ins. L. § 4303(p)(1)(D) to prohibit
cost-sharing for mammography screening for breast cancer in any
contract that provides hospital, surgical or medical care coverage.

*Section 8 would add a new paragraph 5 of Ins. L. § 4303(p) to
prohibit cost-sharing for screening and diagnostic imaging for the
detection of breast cancer, including diagnostic mammograms, breast
ultrasounds, or magnetic resonance imaging, covered under the
contract.

*Section 9 would add a new subsection (qq) to Ins. L. § 4303 to
specify that the provisions requiring a corporation to provide
benefits without cost-sharing shall only apply to: (i) participating
providers in the corporation's network; and (ii) in cases where the
corporation does not have an in-network participating provider with
the appropriate training and experience to meet the health care needs
of the covered person, nonparticipating providers.

Section 10 of the bill would add a new section 2404-d to the Public
Health L. to require any general hospital or extension clinic
certified as a mammography facility under the federal Mammography
Quality Standards Act (MQSA), to provide extended hours for screening
mammography services. Such hours must be in the early morning,
evening, or on the weekend, at least two days each week for at least
two hours each day, for a total of at least four hours each week.
Such hours must include the following times:

o Monday through Friday, between the hours of 7:00 AM and 9:00 AM;
o Monday through Friday, between the hours of 5:00 PM and 7:00 PM; or
o Saturday or Sunday, between the hours of 9:00 AM and 5:00 PM.

Section 10 would also allow the Department of Health to grant a waiver
to facilities that: (i) have insufficient staff; (ii) are in the
process of discontinuing screening mammography services; or (iii) are
subject to hardships.

Section 11 of the bill would amend Civ. Serv. L. § 159-b to repeal a
provision excluding public employees in cities having a population of
one million or more from receiving up to four hours of paid leave to
get a screening for breast cancer.

Section 12 would set forth the effective dates.

 STATEMENT IN SUPPORT :

Breast cancer is the most commonly diagnosed cancer and the second
leading cause of cancer deaths among women in New York State. Each
year, approximately 15,000 women are newly diagnosed with breast
cancer, and approximately 2,640 die from the disease.

Screening for breast cancer, which includes mammography, can increase
the detection of the disease at an early stage when treatment is most
effective. In 2014, however, nearly 22% of women in New York aged
50-74 reported not having mammograms at least every other year.

Under current state law, insurers that provide coverage for
mammography screening for breast cancer must also provide coverage
for:

* mammograms for a covered person of any age that has a prior history
of breast cancer, or a first degree relative with a prior history of
breast cancer when a physician recommends the mammogram;
* a single baseline mammogram for covered persons aged 35 to 39; and

* an annual mammogram for persons aged 40 and older.

However, individuals may still have to pay for such coverage. This
bill would remove that financial barrier by prohibiting cost-sharing
for mammograms and other screening and diagnostic imaging used to
detect breast cancer, including diagnostic mammograms, breast
ultrasounds, and breast MRIs. If an insurer does not have a
participating in-network health provider with the appropriate training
and experience to meet the health care needs of the insured or covered
person, cost-sharing would also be prohibited for services provided by
out of network providers.

This bill will also help individuals whose schedules prevent them from
getting screened. All certified mammography facilities must now
provide extended hours in the early morning, evening, or on the
weekend for a total of at least four hours each week.

Finally, to ensure equity for all public employees throughout the
state, this bill would eliminate a provision in the Civil Service Law
that excludes New York City public employees from receiving up to four
hours of paid leave to get a screening for breast cancer.

 BUDGET IMPLICATIONS :

None.

 EFFECTIVE DATE :
This bill is effective immediately and shall apply to all policies and
contracts issued, renewed, modified, or amended on or after January 1,
2017; provided, however, that section 11 of this bill would take
effect on the ninetieth day after it shall become law; and provided,
further, that effective immediately, the addition, amendment and/or
repeal of any rule or regulation necessary for the implementation of
this bill on its effective date is authorized and directed to be made
and completed on or before such effective date.

2015-S8093 (ACTIVE) - Bill Text download pdf

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

                                  8093

                            I N  S E N A T E

                              June 12, 2016
                               ___________

Introduced  by  Sens.  FLANAGAN,  HANNON,  SEWARD  -- (at request of the
  Governor) -- read twice and ordered printed, and when  printed  to  be
  committed to the Committee on Rules

AN  ACT  to  amend  the  insurance  law, in relation to coverage for the
  detection of breast  cancer;  to  amend  the  public  health  law,  in
  relation  to  requiring  certified  mammography  facilities to provide
  extended hours; and to amend the civil service  law,  in  relation  to
  excused leave to undertake a screening for breast cancer

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

  Section 1. Subparagraph (B) of  paragraph  11  of  subsection  (i)  of
section 3216 of the insurance law, as amended by chapter 219 of the laws
of 2011, is amended to read as follows:
  (B) Such coverage required pursuant to subparagraph (A) or (C) of this
paragraph  [may]  SHALL  NOT  be  subject to annual deductibles [and] OR
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. Paragraph 11 of subsection (i) of section 3216 of  the  insurance
law is amended by adding a new subparagraph (F) to read as follows:
  (F)  SCREENING  AND  DIAGNOSTIC  IMAGING  FOR  THE DETECTION OF BREAST
CANCER, INCLUDING DIAGNOSTIC MAMMOGRAMS, BREAST ULTRASOUNDS, OR MAGNETIC
RESONANCE IMAGING, COVERED UNDER THE POLICY  SHALL  NOT  BE  SUBJECT  TO
ANNUAL DEDUCTIBLES OR COINSURANCE.
  S 3. Subsection (i) of section 3216 of the insurance law is amended by
adding a new paragraph 33 to read as follows:
  (33)  WHENEVER IN THIS SECTION AN INSURER IS REQUIRED TO PROVIDE BENE-
FITS WITH NO COINSURANCE OR DEDUCTIBLE,  THE  REQUIREMENT  ONLY  APPLIES
WITH  RESPECT  TO  PARTICIPATING  PROVIDERS IN THE INSURER'S NETWORK, OR
WITH RESPECT TO NON-PARTICIPATING PROVIDERS, IF  THE  INSURER  DOES  NOT
HAVE  A PARTICIPATING PROVIDER IN THE IN-NETWORK BENEFITS PORTION OF ITS
NETWORK WITH THE APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTIC-
ULAR HEALTH CARE NEEDS OF THE INSURED  PURSUANT  TO  SUBSECTION  (D)  OF
SECTION THREE THOUSAND TWO HUNDRED SEVENTEEN-D OF THIS ARTICLE.

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

                                                           LBD12074-01-6

S. 8093                             2

  S  4.  Subparagraph  (B)  of paragraph 11 of subsection (l) of section
3221 of the insurance law, as amended by chapter  219  of  the  laws  of
2011, is amended to read as follows:
  (B) Such coverage required pursuant to subparagraph (A) or (C) of this
paragraph  [may]  SHALL  NOT  be  subject to annual deductibles [and] OR
coinsurance [as may be deemed appropriate by the superintendent  and  as
are  consistent with those established for other benefits within a given
policy].
  S 5. Paragraph 11 of subsection (l) of section 3221 of  the  insurance
law is amended by adding a new subparagraph (F) to read as follows:
  (F)  SCREENING  AND  DIAGNOSTIC  IMAGING  FOR  THE DETECTION OF BREAST
CANCER, INCLUDING DIAGNOSTIC MAMMOGRAMS, BREAST ULTRASOUNDS, OR MAGNETIC
RESONANCE IMAGING, COVERED UNDER THE POLICY  SHALL  NOT  BE  SUBJECT  TO
ANNUAL DEDUCTIBLES OR COINSURANCE.
  S 6. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 19 to read as follows:
  (19)  WHENEVER IN THIS SECTION AN INSURER IS REQUIRED TO PROVIDE BENE-
FITS WITH NO COINSURANCE OR DEDUCTIBLE,  THE  REQUIREMENT  ONLY  APPLIES
WITH  RESPECT  TO  PARTICIPATING  PROVIDERS IN THE INSURER'S NETWORK, OR
WITH RESPECT TO NON-PARTICIPATING PROVIDERS, IF  THE  INSURER  DOES  NOT
HAVE  A PARTICIPATING PROVIDER IN THE IN-NETWORK BENEFITS PORTION OF ITS
NETWORK WITH THE APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTIC-
ULAR HEALTH CARE NEEDS OF THE INSURED  PURSUANT  TO  SUBSECTION  (D)  OF
SECTION THREE THOUSAND TWO HUNDRED SEVENTEEN-D OF THIS ARTICLE.
  S 7. Subparagraph (D) of paragraph 1 of subsection (p) of section 4303
of  the insurance law, as amended by chapter 219 of the laws of 2011, is
amended to read as follows:
  (D) The coverage required in this paragraph or paragraph two  of  this
subsection  [may]  SHALL  NOT  be subject to annual deductibles [and] OR
coinsurance [as may be deemed appropriate by the superintendent  and  as
are  consistent with those established for other benefits within a given
contract].
  S 8. Subsection (p) of section 4303 of the insurance law is amended by
adding a new paragraph 5 to read as follows:
  (5) SCREENING AND DIAGNOSTIC  IMAGING  FOR  THE  DETECTION  OF  BREAST
CANCER, INCLUDING DIAGNOSTIC MAMMOGRAMS, BREAST ULTRASOUNDS, OR MAGNETIC
RESONANCE  IMAGING,  COVERED  UNDER THE CONTRACT SHALL NOT BE SUBJECT TO
ANNUAL DEDUCTIBLES OR COINSURANCE.
  S 9. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (qq) to read as follows:
  (QQ)  WHENEVER  IN  THIS  SECTION A CORPORATION IS REQUIRED TO PROVIDE
BENEFITS WITH NO COINSURANCE OR DEDUCTIBLE, THE REQUIREMENT ONLY APPLIES
WITH RESPECT TO PARTICIPATING PROVIDERS IN THE CORPORATION'S NETWORK, OR
WITH RESPECT TO NON-PARTICIPATING PROVIDERS, IF THE CORPORATION DOES NOT
HAVE A PARTICIPATING PROVIDER IN THE IN-NETWORK BENEFITS PORTION OF  ITS
NETWORK WITH THE APPROPRIATE TRAINING AND EXPERIENCE TO MEET THE PARTIC-
ULAR  HEALTH CARE NEEDS OF THE COVERED PERSON PURSUANT TO SUBSECTION (D)
OF SECTION FOUR THOUSAND THREE HUNDRED SIX-C  OF  THIS  ARTICLE,  OR  AS
APPLICABLE,  PURSUANT  TO  PARAGRAPH  (A)  OF SUBDIVISION SIX OF SECTION
FORTY-FOUR HUNDRED THREE OF THE PUBLIC HEALTH LAW.
  S 10. The public health law is amended by adding a new section  2404-d
to read as follows:
  S  2404-D.  BREAST CANCER; DUTY TO PROVIDE EXTENDED HOURS. 1. APPLICA-
BILITY. THIS SECTION SHALL APPLY TO ANY GENERAL  HOSPITAL  OR  EXTENSION
CLINIC  THAT  IS  CERTIFIED  AS  A  MAMMOGRAPHY FACILITY PURSUANT TO THE
FEDERAL MAMMOGRAPHY QUALITY STANDARDS ACT (MQSA).

S. 8093                             3

  2. EXTENDED SERVICE HOURS. ANY GENERAL HOSPITAL  OR  EXTENSION  CLINIC
CERTIFIED  AS  A MAMMOGRAPHY FACILITY PURSUANT TO THE MQSA SHALL PROVIDE
EXTENDED HOURS, I.E. IN THE EARLY MORNING, EVENING,  OR  WEEKEND  HOURS,
FOR SCREENING MAMMOGRAPHY SERVICES. EXTENDED HOURS FOR SCREENING MAMMOG-
RAPHY  SERVICES SHALL BE PROVIDED ON AT LEAST TWO DAYS EACH WEEK, FOR AT
LEAST TWO HOURS EACH DAY OFFERED, FOR A TOTAL OF  AT  LEAST  FOUR  HOURS
EACH WEEK, INCLUDING BUT NOT LIMITED TO THE FOLLOWING TIMES:
  (A) MONDAY THROUGH FRIDAY, BETWEEN THE HOURS OF 7:00 AM AND 9:00 AM;
  (B)  MONDAY  THROUGH FRIDAY, BETWEEN THE HOURS OF 5:00 PM AND 7:00 PM;
OR
  (C) SATURDAY OR SUNDAY, BETWEEN THE HOURS OF 9:00 AM AND 5:00 PM.
  3. WAIVER. (A) A FACILITY MAY SUBMIT AN APPLICATION FOR A WAIVER  FROM
THE  REQUIREMENTS OF THIS SECTION, IN WHOLE OR IN PART, IF IT CAN DEMON-
STRATE, TO THE DEPARTMENT'S SATISFACTION, THAT THE FACILITY:
  (I) DOES NOT HAVE SUFFICIENT  STAFF  TO  PROVIDE  EXTENDED  HOURS  FOR
SCREENING MAMMOGRAPHY SERVICES IN ACCORDANCE WITH THIS SECTION, AND THAT
IT  IS  MAKING  DILIGENT  EFFORTS  TO  OBTAIN  STAFFING SUCH THAT IT CAN
PROVIDE EXTENDED HOURS;
  (II)  IS  IN  THE  PROCESS  OF  DISCONTINUING  SCREENING   MAMMOGRAPHY
SERVICES, AS PART OF A CONSOLIDATION OR SIMILAR CHANGE; OR
  (III)  IS  SUBJECT  TO  SUCH  OTHER  HARDSHIPS AS THE DEPARTMENT DEEMS
APPROPRIATE.
  (B) THE DEPARTMENT MAY DENY, GRANT OR  EXTEND  A  WAIVER  PURSUANT  TO
PARAGRAPH  (A)  OF  THIS  SUBDIVISION  FOR  NINETY  DAYS, OR MORE IF THE
DEPARTMENT DETERMINES APPROPRIATE, IN ITS SOLE DISCRETION.
  S 11. Subdivision 3 of section 159-b of  the  civil  service  law,  as
added by chapter 566 of the laws of 2006, is amended to read as follows:
  [3.  The provisions of this section shall not apply to any employee of
a city having a population of one million or more.]
  S 12. This act shall take effect immediately and shall apply to  poli-
cies  and  contracts  issued,  renewed, modified or amended  on or after
January 1, 2017; provided, however, that  section  eleven  of  this  act
shall take effect on the ninetieth day after it shall have become a law;
and  provided, further, that effective immediately, the addition, amend-
ment and/or repeal of any rule or regulation necessary for the implemen-
tation of this act on its effective date is authorized and  directed  to
be made and completed on or before such effective date.

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Senate Bill S8093

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Sponsored By

John J. Flanagan

Archive: Last Bill Status - Signed by Governor

co-Sponsors

Kemp Hannon

James L. Seward

John J. Bonacic

Jack M. Martins

2015-S8093 (ACTIVE) - Details

2015-S8093 (ACTIVE) - Summary

2015-S8093 (ACTIVE) - Sponsor Memo

2015-S8093 (ACTIVE) - Bill Text download pdf

Comments