S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2936
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 28, 2019
                                ___________
 
 Introduced  by  M.  of A. SOLAGES, BUCHWALD -- read once and referred 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.
   § 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) 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD05021-01-9

 A. 2936                             2
 
 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.
   § 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.
   §  4. This act shall take effect on the first of January next succeed-
 ing the date on which it shall have become a law.