NY State Senate Bill 2021-S8147

Senate Bill S8147

2021-2022 Legislative Session

Requires health insurance policies and medicaid to cover biomarker testing for certain purposes

download bill text pdf

Archive: Last Bill Status - In Senate Committee Insurance Committee

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 26, 2022	referred to insurance

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2021-S8147 (ACTIVE) - Details

See Assembly Version of this Bill:: A9149
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L
Versions Introduced in 2023-2024 Legislative Session:: S1196, A1673

2021-S8147 (ACTIVE) - Summary

Requires health insurance policies and medicaid to cover biomarker testing for diagnosis, treatment, appropriate management, or ongoing monitoring of a covered person's disease or condition when the test is supported by medical and scientific evidence.

2021-S8147 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S8147

SPONSOR: PERSAUD
 
TITLE OF BILL:

An act to amend the insurance law and the social services law, in
relation to requiring health insurance policies and medicaid to cover
biomarker testing for certain purposes

 
PURPOSE OR GENERAL IDEA OF BILL:

This legislation will require that every state-regulated insurance plan,
including Medicaid, provides coverage for biomarker testing when
medically appropriate.

 
SUMMARY OF PROVISIONS:

Section 1 requires every individual accident and health insurance policy
that provides coverage for medical, major medical, or similar comprehen-
sive-type coverage shall provide coverage for biomarker testing for the
purposes of diagnosis, treatment, appropriate management, or ongoing
monitoring of a covered person's disease or condition. Defines criteria

for what types of medical and scientific evidence qualify as sufficient
medical and scientific evidence for biomarker testing.

Section 2 applies these same provisions to group or blanket accident and
health insurance policies

Section 3 applies these same provisions to all hospital service corpo-
ration or health service corporation

Section 4 applies these same provisions to Medicaid Section 5 provides
for the effective date

 
JUSTIFICATION:

In cancer care, biomarkers are often used to help determine the best
treatment for a patient. A "biomarker" is a sign of disease or abnormal
function that can be measured in blood, tissue, or bodily fluid.
Biomarker testing is the analysis of a patient's tissue, blood or fluid
biospecimen for the presence of a biomarker.

Progress in improving cancer outcomes increasingly involves the use of
precision medicine. Biomarker testing is an important step for accessing
precision medicine, including targeted therapies that can improve survi-
vorship and better cancer patients' quality of life.  Biomarker testing
is increasingly important for cancer care and for the treatment of other
diseases. Thirty- seven of the 62 oncology drugs launched in the past
five years require or recommend biomarker testing before use.

This legislation will ensure New Yorkers covered by state-regulated
insurance plans, including Medicaid, have coverage for biomarker testing
when medically appropriate.

Improving access to biomarker testing and thereby access to targeted
therapies is a strategy to reduce health disparities and improve
outcomes for cancer patients.


Ensuring equitable access to biomarker testing by improving coverage for
and access to testing across insurance types is key to reducing health
disparities. Indeed, without action like this to expand coverage for
biomarker testing - including Medicaid - advances in precision oncology
could increase existing health disparities.

Legislation to expand coverage of biomarker testing in New York would
make it possible for more patients to get the proper treatment at the
right time.

 
PRIOR LEGISLATIVE HISTORY:

New Bill

 
FISCAL IMPLICATIONS:

Any cost of enacting this legislation is far overshadowed by ensuring
that the course of treatment used in treating an individual patient's
cancer is the most effective and cost-effective treatment.

 
EFFECTIVE DATE:
First of January, succeeding the date on which it shall become a law.

2021-S8147 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8147
 
                             I N  S E N A T E
 
                             January 26, 2022
                                ___________
 
 Introduced  by  Sen. PERSAUD -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance  law  and  the  social  services  law,  in
   relation  to requiring health insurance policies and medicaid to cover
   biomarker testing for certain purposes
 
   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 WHICH  PROVIDES  MEDICAL,  MAJOR  MEDICAL,  OR
 SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR BIOMARKER
 TESTING  FOR  THE  PURPOSES OF DIAGNOSIS, TREATMENT, APPROPRIATE MANAGE-
 MENT, OR ONGOING MONITORING OF A COVERED PERSON'S DISEASE  OR  CONDITION
 WHEN  THE  TEST IS SUPPORTED BY MEDICAL AND SCIENTIFIC EVIDENCE, INCLUD-
 ING, BUT NOT LIMITED TO:
   (I) LABELED INDICATIONS FOR A TEST APPROVED OR CLEARED BY THE FOOD AND
 DRUG ADMINISTRATION OF THE UNITED STATES GOVERNMENT OR  INDICATED  TESTS
 FOR A FOOD AND DRUG ADMINISTRATION APPROVED DRUG;
   (II)  CENTERS  FOR  MEDICARE  AND  MEDICAID SERVICES NATIONAL COVERAGE
 DETERMINATIONS AND MEDICARE  ADMINISTRATIVE  CONTRACTOR  LOCAL  COVERAGE
 DETERMINATIONS; OR
   (III) NATIONALLY RECOGNIZED CLINICAL PRACTICE GUIDELINES AND CONSENSUS
 STATEMENTS.
   (B)  SUCH  COVERAGE  SHALL  BE  PROVIDED  IN A MANNER THAT SHALL LIMIT
 DISRUPTIONS IN CARE INCLUDING THE NEED FOR MULTIPLE BIOPSIES OR  BIOSPE-
 CIMEN SAMPLES.
   (C)  THE COVERED PERSON AND PRESCRIBING PRACTITIONER SHALL HAVE ACCESS
 TO A CLEAR, READILY ACCESSIBLE, AND CONVENIENT  PROCESS  TO  REQUEST  AN
 EXCEPTION  TO  A  COVERAGE POLICY PROVIDED PURSUANT TO THE PROVISIONS OF
 THIS PARAGRAPH. SUCH PROCESS SHALL BE MADE  READILY  ACCESSIBLE  ON  THE
 WEBSITE OF THE INSURER.
   (D)  AS  USED  IN  THIS  PARAGRAPH, THE FOLLOWING TERMS SHALL HAVE THE
 FOLLOWING MEANINGS:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD13311-02-2

 S. 8147                             2
 
   (I) "BIOMARKER" MEANS A CHARACTERISTIC THAT  IS  OBJECTIVELY  MEASURED
 AND EVALUATED AS AN INDICATOR OF NORMAL BIOLOGICAL PROCESSES, PATHOGENIC
 PROCESSES,  OR  PHARMACOLOGIC RESPONSES TO A SPECIFIC THERAPEUTIC INTER-
 VENTION. BIOMARKERS INCLUDE BUT ARE NOT LIMITED  TO  GENE  MUTATIONS  OR
 PROTEIN EXPRESSION.
   (II)  "BIOMARKER  TESTING"  MEANS  THE ANALYSIS OF A PATIENT'S TISSUE,
 BLOOD, OR OTHER BIOSPECIMEN FOR THE PRESENCE OF A  BIOMARKER.  BIOMARKER
 TESTING  INCLUDES BUT IS NOT LIMITED TO SINGLE-ANALYTE TESTS, MULTI-PLEX
 PANEL TESTS, AND WHOLE GENOME SEQUENCING.
   (III) "CONSENSUS STATEMENTS" MEANS STATEMENTS DEVELOPED  BY  AN  INDE-
 PENDENT,  MULTIDISCIPLINARY  PANEL  OF  EXPERTS  UTILIZING A TRANSPARENT
 METHODOLOGY AND REPORTING STRUCTURE AND  WITH  A  CONFLICT  OF  INTEREST
 POLICY. SUCH STATEMENTS ARE AIMED AT SPECIFIC CLINICAL CIRCUMSTANCES AND
 BASE  THE  STATEMENTS  ON THE BEST AVAILABLE EVIDENCE FOR THE PURPOSE OF
 OPTIMIZING THE OUTCOMES OF CLINICAL CARE.
   (IV)  "NATIONALLY  RECOGNIZED  CLINICAL  PRACTICE  GUIDELINES"   MEANS
 EVIDENCE-BASED  CLINICAL  PRACTICE  GUIDELINES  DEVELOPED BY INDEPENDENT
 ORGANIZATIONS OR MEDICAL PROFESSIONAL SOCIETIES UTILIZING A  TRANSPARENT
 METHODOLOGY  AND  REPORTING  STRUCTURE  AND  WITH A CONFLICT OF INTEREST
 POLICY.  CLINICAL  PRACTICE  GUIDELINES  ESTABLISH  STANDARDS  OF   CARE
 INFORMED  BY  A  SYSTEMATIC  REVIEW OF EVIDENCE AND AN ASSESSMENT OF THE
 BENEFITS AND COSTS OF ALTERNATIVE CARE OPTIONS AND  INCLUDE  RECOMMENDA-
 TIONS INTENDED TO OPTIMIZE PATIENT CARE.
   § 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 INSURER DELIVERING A GROUP OR BLANKET POLICY OR ISSU-
 ING  A  GROUP OR BLANKET POLICY FOR DELIVERY IN THIS STATE THAT PROVIDES
 COVERAGE FOR  MEDICAL,  MAJOR  MEDICAL,  OR  SIMILAR  COMPREHENSIVE-TYPE
 COVERAGE  SHALL  PROVIDE COVERAGE FOR BIOMARKER TESTING FOR THE PURPOSES
 OF DIAGNOSIS, TREATMENT, APPROPRIATE MANAGEMENT, OR  ONGOING  MONITORING
 OF A COVERED PERSON'S DISEASE OR CONDITION WHEN THE TEST IS SUPPORTED BY
 MEDICAL AND SCIENTIFIC EVIDENCE, INCLUDING, BUT NOT LIMITED TO:
   (I) LABELED INDICATIONS FOR A TEST APPROVED OR CLEARED BY THE FOOD AND
 DRUG  ADMINISTRATION  OF THE UNITED STATES GOVERNMENT OR INDICATED TESTS
 FOR A FOOD AND DRUG ADMINISTRATION APPROVED DRUG;
   (II) CENTERS FOR MEDICARE  AND  MEDICAID  SERVICES  NATIONAL  COVERAGE
 DETERMINATIONS  AND  MEDICARE  ADMINISTRATIVE  CONTRACTOR LOCAL COVERAGE
 DETERMINATIONS; OR
   (III) NATIONALLY RECOGNIZED CLINICAL PRACTICE GUIDELINES AND CONSENSUS
 STATEMENTS.
   (B) SUCH COVERAGE SHALL BE PROVIDED  IN  A  MANNER  THAT  SHALL  LIMIT
 DISRUPTIONS  IN CARE INCLUDING THE NEED FOR MULTIPLE BIOPSIES OR BIOSPE-
 CIMEN SAMPLES.
   (C) THE COVERED PERSON AND PRESCRIBING PRACTITIONER SHALL HAVE  ACCESS
 TO  A  CLEAR,  READILY  ACCESSIBLE, AND CONVENIENT PROCESS TO REQUEST AN
 EXCEPTION TO A COVERAGE POLICY PROVIDED PURSUANT TO  THE  PROVISIONS  OF
 THIS  PARAGRAPH.  SUCH  PROCESS  SHALL BE MADE READILY ACCESSIBLE ON THE
 WEBSITE OF THE INSURER.
   (D) AS USED IN THIS PARAGRAPH, THE  FOLLOWING  TERMS  SHALL  HAVE  THE
 FOLLOWING MEANINGS:
   (I)  "BIOMARKER"  MEANS  A CHARACTERISTIC THAT IS OBJECTIVELY MEASURED
 AND EVALUATED AS AN INDICATOR OF NORMAL BIOLOGICAL PROCESSES, PATHOGENIC
 PROCESSES, OR PHARMACOLOGIC RESPONSES TO A SPECIFIC  THERAPEUTIC  INTER-
 VENTION.  BIOMARKERS  INCLUDE  BUT  ARE NOT LIMITED TO GENE MUTATIONS OR
 PROTEIN EXPRESSION.
 S. 8147                             3
 
   (II) "BIOMARKER TESTING" MEANS THE ANALYSIS  OF  A  PATIENT'S  TISSUE,
 BLOOD,  OR  OTHER BIOSPECIMEN FOR THE PRESENCE OF A BIOMARKER. BIOMARKER
 TESTING INCLUDES BUT IS NOT LIMITED TO SINGLE-ANALYTE TESTS,  MULTI-PLEX
 PANEL TESTS, AND WHOLE GENOME SEQUENCING.
   (III)  "CONSENSUS  STATEMENTS"  MEANS STATEMENTS DEVELOPED BY AN INDE-
 PENDENT, MULTIDISCIPLINARY PANEL  OF  EXPERTS  UTILIZING  A  TRANSPARENT
 METHODOLOGY  AND  REPORTING  STRUCTURE  AND  WITH A CONFLICT OF INTEREST
 POLICY. SUCH STATEMENTS ARE AIMED AT SPECIFIC CLINICAL CIRCUMSTANCES AND
 BASE THE STATEMENTS ON THE BEST AVAILABLE EVIDENCE FOR  THE  PURPOSE  OF
 OPTIMIZING THE OUTCOMES OF CLINICAL CARE.
   (IV)   "NATIONALLY  RECOGNIZED  CLINICAL  PRACTICE  GUIDELINES"  MEANS
 EVIDENCE-BASED CLINICAL PRACTICE  GUIDELINES  DEVELOPED  BY  INDEPENDENT
 ORGANIZATIONS  OR MEDICAL PROFESSIONAL SOCIETIES UTILIZING A TRANSPARENT
 METHODOLOGY AND REPORTING STRUCTURE AND  WITH  A  CONFLICT  OF  INTEREST
 POLICY.   CLINICAL  PRACTICE  GUIDELINES  ESTABLISH  STANDARDS  OF  CARE
 INFORMED BY A SYSTEMATIC REVIEW OF EVIDENCE AND  AN  ASSESSMENT  OF  THE
 BENEFITS  AND  COSTS OF ALTERNATIVE CARE OPTIONS AND INCLUDE RECOMMENDA-
 TIONS INTENDED TO OPTIMIZE PATIENT CARE.
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (p-1) to read as follows:
   (P-1)  (1) A MEDICAL EXPENSE INDEMNITY CORPORATION, A HOSPITAL SERVICE
 CORPORATION OR A HEALTH SERVICE CORPORATION THAT PROVIDES  COVERAGE  FOR
 MEDICAL,  MAJOR  MEDICAL,  OR  SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL
 PROVIDE COVERAGE FOR BIOMARKER TESTING FOR THE  PURPOSES  OF  DIAGNOSIS,
 TREATMENT,  APPROPRIATE  MANAGEMENT,  OR ONGOING MONITORING OF A COVERED
 PERSON'S DISEASE OR CONDITION WHEN THE TEST IS SUPPORTED BY MEDICAL  AND
 SCIENTIFIC EVIDENCE, INCLUDING, BUT NOT LIMITED TO:
   (A) LABELED INDICATIONS FOR A TEST APPROVED OR CLEARED BY THE FOOD AND
 DRUG  ADMINISTRATION  OF THE UNITED STATES GOVERNMENT OR INDICATED TESTS
 FOR A FOOD AND DRUG ADMINISTRATION APPROVED DRUG;
   (B) CENTERS FOR  MEDICARE  AND  MEDICAID  SERVICES  NATIONAL  COVERAGE
 DETERMINATIONS  AND  MEDICARE  ADMINISTRATIVE  CONTRACTOR LOCAL COVERAGE
 DETERMINATIONS; OR
   (C) NATIONALLY RECOGNIZED CLINICAL PRACTICE GUIDELINES  AND  CONSENSUS
 STATEMENTS.
   (2)  SUCH  COVERAGE  SHALL  BE  PROVIDED  IN A MANNER THAT SHALL LIMIT
 DISRUPTIONS IN CARE INCLUDING THE NEED FOR MULTIPLE BIOPSIES OR  BIOSPE-
 CIMEN SAMPLES.
   (3)  THE COVERED PERSON AND PRESCRIBING PRACTITIONER SHALL HAVE ACCESS
 TO A CLEAR, READILY ACCESSIBLE, AND CONVENIENT  PROCESS  TO  REQUEST  AN
 EXCEPTION  TO  A  COVERAGE POLICY PROVIDED PURSUANT TO THE PROVISIONS OF
 THIS SUBSECTION. SUCH PROCESS SHALL BE MADE READILY  ACCESSIBLE  ON  THE
 WEBSITE OF THE INSURER.
   (4)  AS  USED  IN  THIS SUBSECTION, THE FOLLOWING TERMS SHALL HAVE THE
 FOLLOWING MEANINGS:
   (A) "BIOMARKER" MEANS A CHARACTERISTIC THAT  IS  OBJECTIVELY  MEASURED
 AND EVALUATED AS AN INDICATOR OF NORMAL BIOLOGICAL PROCESSES, PATHOGENIC
 PROCESSES,  OR  PHARMACOLOGIC RESPONSES TO A SPECIFIC THERAPEUTIC INTER-
 VENTION. BIOMARKERS INCLUDE BUT ARE NOT LIMITED  TO  GENE  MUTATIONS  OR
 PROTEIN EXPRESSION.
   (B)  "BIOMARKER  TESTING"  MEANS  THE  ANALYSIS OF A PATIENT'S TISSUE,
 BLOOD, OR OTHER BIOSPECIMEN FOR THE PRESENCE OF A  BIOMARKER.  BIOMARKER
 TESTING  INCLUDES BUT IS NOT LIMITED TO SINGLE-ANALYTE TESTS, MULTI-PLEX
 PANEL TESTS, AND WHOLE GENOME SEQUENCING.
   (C) "CONSENSUS STATEMENTS" MEANS STATEMENTS DEVELOPED BY AN  INDEPEND-
 ENT,  MULTIDISCIPLINARY PANEL OF EXPERTS UTILIZING A TRANSPARENT METHOD-
 S. 8147                             4
 
 OLOGY AND REPORTING STRUCTURE AND WITH A CONFLICT  OF  INTEREST  POLICY.
 SUCH  STATEMENTS  ARE  AIMED AT SPECIFIC CLINICAL CIRCUMSTANCES AND BASE
 THE STATEMENTS ON THE BEST AVAILABLE EVIDENCE FOR THE PURPOSE  OF  OPTI-
 MIZING THE OUTCOMES OF CLINICAL CARE.
   (D)   "NATIONALLY   RECOGNIZED  CLINICAL  PRACTICE  GUIDELINES"  MEANS
 EVIDENCE-BASED CLINICAL PRACTICE  GUIDELINES  DEVELOPED  BY  INDEPENDENT
 ORGANIZATIONS  OR MEDICAL PROFESSIONAL SOCIETIES UTILIZING A TRANSPARENT
 METHODOLOGY AND REPORTING STRUCTURE AND  WITH  A  CONFLICT  OF  INTEREST
 POLICY.   CLINICAL  PRACTICE  GUIDELINES  ESTABLISH  STANDARDS  OF  CARE
 INFORMED BY A SYSTEMATIC REVIEW OF EVIDENCE AND  AN  ASSESSMENT  OF  THE
 BENEFITS  AND  COSTS OF ALTERNATIVE CARE OPTIONS AND INCLUDE RECOMMENDA-
 TIONS INTENDED TO OPTIMIZE PATIENT CARE.
   § 4. Subdivision 2 of section 365-a of  the  social  services  law  is
 amended by adding a new paragraph (jj) to read as follows:
   (JJ)  (I)  BIOMARKER TESTING FOR THE PURPOSES OF DIAGNOSIS, TREATMENT,
 APPROPRIATE MANAGEMENT, OR ONGOING MONITORING OF A  RECIPIENT'S  DISEASE
 OR  CONDITION  WHEN  THE  TEST  IS  SUPPORTED  BY MEDICAL AND SCIENTIFIC
 EVIDENCE, INCLUDING, BUT NOT LIMITED TO:
   (1) LABELED INDICATIONS FOR A TEST APPROVED OR CLEARED BY THE FOOD AND
 DRUG ADMINISTRATION OF THE UNITED STATES GOVERNMENT OR  INDICATED  TESTS
 FOR A FOOD AND DRUG ADMINISTRATION APPROVED DRUG;
   (2)  CENTERS  FOR  MEDICARE  AND  MEDICAID  SERVICES NATIONAL COVERAGE
 DETERMINATIONS AND MEDICARE  ADMINISTRATIVE  CONTRACTOR  LOCAL  COVERAGE
 DETERMINATIONS; OR
   (3)  NATIONALLY  RECOGNIZED CLINICAL PRACTICE GUIDELINES AND CONSENSUS
 STATEMENTS.
   (II) RISK-BEARING ENTITIES  CONTRACTED  TO  THE  MEDICAID  PROGRAM  TO
 DELIVER  SERVICES  TO  RECIPIENTS SHALL PROVIDE BIOMARKER TESTING AT THE
 SAME SCOPE, DURATION AND FREQUENCY AS  THE  MEDICAID  PROGRAM  OTHERWISE
 PROVIDES TO ENROLLEES.
   (III)  THE RECIPIENT AND PARTICIPATING PROVIDER SHALL HAVE ACCESS TO A
 CLEAR, READILY ACCESSIBLE, AND CONVENIENT PROCESS TO REQUEST  AN  EXCEP-
 TION  TO  A  COVERAGE  POLICY OF THE MEDICAID PROGRAM OR BY RISK-BEARING
 ENTITIES CONTRACTED TO THE MEDICAID PROGRAM. SUCH PROCESS SHALL BE  MADE
 READILY ACCESSIBLE TO ALL PARTICIPATING PROVIDERS AND ENROLLEES ONLINE.
   (IV)  AS  USED  IN  THIS PARAGRAPH, THE FOLLOWING TERMS SHALL HAVE THE
 FOLLOWING MEANINGS:
   (1) "BIOMARKER" MEANS A CHARACTERISTIC THAT  IS  OBJECTIVELY  MEASURED
 AND EVALUATED AS AN INDICATOR OF NORMAL BIOLOGICAL PROCESSES, PATHOGENIC
 PROCESSES,  OR  PHARMACOLOGIC RESPONSES TO A SPECIFIC THERAPEUTIC INTER-
 VENTION. BIOMARKERS INCLUDE BUT ARE NOT LIMITED  TO  GENE  MUTATIONS  OR
 PROTEIN EXPRESSION.
   (2)  "BIOMARKER  TESTING"  MEANS  THE  ANALYSIS OF A PATIENT'S TISSUE,
 BLOOD, OR OTHER BIOSPECIMEN FOR THE PRESENCE OF A  BIOMARKER.  BIOMARKER
 TESTING  INCLUDES BUT IS NOT LIMITED TO SINGLE-ANALYTE TESTS, MULTI-PLEX
 PANEL TESTS, AND WHOLE GENOME SEQUENCING.
   (3) "CONSENSUS STATEMENTS" MEANS STATEMENTS DEVELOPED BY AN  INDEPEND-
 ENT,  MULTIDISCIPLINARY PANEL OF EXPERTS UTILIZING A TRANSPARENT METHOD-
 OLOGY AND REPORTING STRUCTURE AND WITH A CONFLICT  OF  INTEREST  POLICY.
 SUCH  STATEMENTS  ARE  AIMED AT SPECIFIC CLINICAL CIRCUMSTANCES AND BASE
 THE STATEMENTS ON THE BEST AVAILABLE EVIDENCE FOR THE PURPOSE  OF  OPTI-
 MIZING THE OUTCOMES OF CLINICAL CARE.
   (4)   "NATIONALLY   RECOGNIZED  CLINICAL  PRACTICE  GUIDELINES"  MEANS
 EVIDENCE-BASED CLINICAL PRACTICE  GUIDELINES  DEVELOPED  BY  INDEPENDENT
 ORGANIZATIONS  OR MEDICAL PROFESSIONAL SOCIETIES UTILIZING A TRANSPARENT
 METHODOLOGY AND REPORTING STRUCTURE AND  WITH  A  CONFLICT  OF  INTEREST
 S. 8147                             5
 
 POLICY.   CLINICAL  PRACTICE  GUIDELINES  ESTABLISH  STANDARDS  OF  CARE
 INFORMED BY A SYSTEMATIC REVIEW OF EVIDENCE AND  AN  ASSESSMENT  OF  THE
 BENEFITS  AND  COSTS OF ALTERNATIVE CARE OPTIONS AND INCLUDE RECOMMENDA-
 TIONS INTENDED TO OPTIMIZE PATIENT CARE.
   § 5. This act shall take effect January 1, 2023 and shall apply to all
 policies  and contracts issued, renewed, modified, altered or amended on
 or after such date.

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