S T A T E O F N E W Y O R K
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2198
2023-2024 Regular Sessions
I N A S S E M B L Y
January 23, 2023
___________
Introduced by M. of A. DINOWITZ -- read once and referred to the Commit-
tee on Insurance
AN ACT to amend the insurance law and a chapter of the laws of 2022
relating to providing insurance coverage for colorectal cancer early
detection, as proposed in legislative bills numbers S. 906-B and A.
2085-A, in relation to coverage for preventive screenings and notice
requirements; and to repeal certain provisions of the insurance law
and of such chapter relating thereto
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Paragraph 11-b of subsection (i) of section 3216 of the
insurance law, as added by a chapter of the laws of 2022 amending the
insurance law relating to providing insurance coverage for colorectal
cancer early detection, as proposed in legislative bills numbers S.906-B
and A. 2085-A, is REPEALED.
§ 2. Paragraph 11-b of subsection (l) of section 3221 of the insurance
law, as added by a chapter of the laws of 2022 amending the insurance
law relating to providing insurance coverage for colorectal cancer
early detection, as proposed in legislative bills numbers S.906-B and A.
2085-A, is amended to read as follows:
(11-b) (A) Every LARGE GROUP 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 LARGE GROUP 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] ACTING WITHIN THE PROVIDER'S SCOPE OF
PRACTICE PURSUANT TO title eight of the education law, coverage for
colorectal cancer [screening] PREVENTIVE SCREENINGS IN ACCORDANCE WITH
THE AMERICAN CANCER SOCIETY GUIDELINES FOR COLORECTAL CANCER SCREENING
OF AVERAGE RISK INDIVIDUALS. The coverage required by this paragraph
shall ALSO include [preventive colorectal cancer screening] coverage for
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04015-01-3
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all ADDITIONAL colorectal cancer examinations and laboratory tests
RECOMMENDED in accordance with THE American Cancer Society Guidelines
for colorectal cancer screening of average risk individuals, including
an initial colonoscopy or other medical test or procedure for colorectal
cancer screening and a follow-up colonoscopy performed as a result of a
positive result on a non-colonoscopy preventive screening test. A LARGE
GROUP POLICY SHALL COVER COLORECTAL CANCER SCREENINGS, EXAMINATIONS, AND
LABORATORY TESTS DESCRIBED IN THIS PARAGRAPH UPON ANY POLICY ISSUANCE OR
RENEWAL THAT OCCURS SIX MONTHS AFTER THE DATE THE GUIDELINE DESCRIBED IN
THIS PARAGRAPH IS ISSUED.
(B) An [individual] INSURED shall not be subject to a deductible,
coinsurance, or any other cost-sharing requirements for services
consistent with subparagraph (A) of this paragraph received from partic-
ipating providers.
§ 3. Section 4303 of the insurance law is amended by adding a new
subsection (uu) to read as follows:
(UU) (1) EVERY LARGE GROUP CONTRACT 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 LARGE GROUP
CONTRACT WHICH PROVIDES MAJOR MEDICAL OR SIMILAR COMPREHENSIVE-TYPE
COVERAGE SHALL PROVIDE, UPON THE PRESCRIPTION OF A HEALTH CARE PROVIDER
ACTING WITHIN THE PROVIDER'S SCOPE OF PRACTICE PURSUANT TO TITLE EIGHT
OF THE EDUCATION LAW, COVERAGE FOR COLORECTAL CANCER PREVENTIVE SCREEN-
INGS IN ACCORDANCE WITH THE AMERICAN CANCER SOCIETY GUIDELINES FOR COLO-
RECTAL CANCER SCREENING OF AVERAGE RISK INDIVIDUALS. THE COVERAGE
REQUIRED BY THIS SUBSECTION SHALL ALSO INCLUDE COVERAGE FOR ALL ADDI-
TIONAL COLORECTAL CANCER EXAMINATIONS AND LABORATORY TESTS RECOMMENDED
IN ACCORDANCE WITH THE AMERICAN CANCER SOCIETY GUIDELINES FOR COLORECTAL
CANCER SCREENING OF AVERAGE RISK INDIVIDUALS, INCLUDING AN INITIAL COLO-
NOSCOPY OR OTHER MEDICAL TEST OR PROCEDURE FOR COLORECTAL CANCER SCREEN-
ING AND A FOLLOW-UP COLONOSCOPY PERFORMED AS A RESULT OF A POSITIVE
RESULT ON A NON-COLONOSCOPY PREVENTIVE SCREENING TEST. A LARGE GROUP
CONTRACT SHALL COVER COLORECTAL CANCER SCREENINGS, EXAMINATIONS, AND
LABORATORY TESTS DESCRIBED IN THIS SUBSECTION UPON ANY CONTRACT ISSUANCE
OR RENEWAL THAT OCCURS SIX MONTHS AFTER THE DATE THE GUIDELINE DESCRIBED
IN THIS SUBSECTION IS ISSUED.
(2) AN ENROLLEE SHALL NOT BE SUBJECT TO A DEDUCTIBLE, COINSURANCE, OR
ANY OTHER COST-SHARING REQUIREMENTS FOR SERVICES CONSISTENT WITH PARA-
GRAPH ONE OF THIS SUBSECTION RECEIVED FROM PARTICIPATING PROVIDERS.
§ 4. Section 3 of a chapter of the laws of 2022 relating to providing
insurance coverage for colorectal cancer early detection, as proposed in
legislative bills numbers S.906-B and A. 2085-A, is REPEALED.
§ 5. The insurance law is amended by adding a new section 339 to read
as follows:
§ 339. COLORECTAL CANCER SCREENING NOTIFICATION. THE SUPERINTENDENT
SHALL REQUIRE AN INSURER AUTHORIZED TO WRITE ACCIDENT AND HEALTH INSUR-
ANCE IN THIS STATE, A CORPORATION ORGANIZED PURSUANT TO ARTICLE FORTY-
THREE OF THIS CHAPTER, AND A HEALTH MAINTENANCE ORGANIZATION CERTIFIED
PURSUANT TO ARTICLE FORTY-FOUR OF THE PUBLIC HEALTH LAW TO NOTIFY
INSUREDS AND ENROLLEES AT LEAST ANNUALLY OF COLORECTAL CANCER SCREENINGS
COVERED BY SUCH INSUREDS' OR ENROLLEES' HEALTH INSURANCE POLICY OR
CONTRACT, AND OF THE MOST RECENTLY PUBLISHED GUIDELINES OF THE AMERICAN
CANCER SOCIETY FOR COLORECTAL CANCER SCREENINGS THAT ARE COVERED BY SUCH
INSUREDS' OR ENROLLEES' HEALTH INSURANCE POLICY OR CONTRACT. THE NOTICE
SHALL BE DELIVERED BY UNITED STATES POSTAL MAIL UNLESS THE INSURED OR
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ENROLLEE CONSENTS TO ANOTHER METHOD OF NOTIFICATION, INCLUDING ELECTRON-
IC NOTIFICATION.
§ 6. Section 4 of a chapter of the laws of 2022 relating to providing
insurance coverage for colorectal cancer early detection, as proposed in
legislative bills numbers S.906-B and A. 2085-A, is amended to read as
follows:
§ 4. This act shall take effect immediately and shall apply to any
policy issued, [delivered,] renewed, [and/or] modified, ALTERED, OR
AMENDED on or after the effective date of this act.
§ 7. This act shall take effect immediately; provided that sections
one, two, three, four and five of this act shall take effect on the same
date and in the same manner as of a chapter of the laws of 2022 relating
to providing insurance coverage for colorectal cancer early detection,
as proposed in legislative bills numbers S.906-B and A. 2085-A, takes
effect.