NY State Senate Bill 2023-S1187

Senate Bill S1187

2023-2024 Legislative Session

Requires health insurance policies to offer full coverage for annual testing for ovarian cancer and requires certain health care providers offer annual testing for ovarian cancer

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Current 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 03, 2024	referred to insurance
Jan 10, 2023	referred to insurance

co-Sponsors

2023-S1187 (ACTIVE) - Details

See Assembly Version of this Bill:: A1641
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L; add §2405-a, Pub Health L
Versions Introduced in 2021-2022 Legislative Session:: S8178, A9228

2023-S1187 (ACTIVE) - Summary

Requires health insurance policies to offer full coverage for annual testing for ovarian cancer; requires certain health care providers offer annual testing for ovarian cancer.

2023-S1187 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S1187

SPONSOR: PERSAUD
 
TITLE OF BILL:

An act to amend the insurance law, the social services law and the
public health law, in relation to requiring health insurance policies to
fully cover testing for ovarian cancer and requiring certain health care
providers to offer annual testing for ovarian cancer

 
PURPOSE OR GENERAL IDEA OF BILL:

Requires health insurance policies to fully cover testing for ovarian
cancer and requires certain healthcare providers to offer annual testing
for ovarian cancer

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1. Every policy that provides coverage for hospital, surgical or
medical care shall offer full coverage for annual testing to patients
that are at high-risk of developing ovarian cancer including, but not
limited to, FDA-approved testing, transvaginal ultrasound, pelvic exam,

and other exams regardless if presenting signs and symptoms

Section 2. Applies the same provisions to every insurer delivering a
group or blanket policy or issuing a group or blanket policy for deliv-
ery in this state that provides coverage for hospital, surgical or
medical care.

Section 3. Applies these same provisions to a medical expense indemnity
corporation, a hospital service corporation, or a health service corpo-
ration that provides coverage for hospital, surgical, or medical care.

Section 4. Annual ovarian cancer testing including, but not limited to,
FDA testing, pelvic exam, transvaginal ultrasound, and other exams to be
made readily available to those at risk or high-risk for cancer regard-
less if presenting signs and symptoms.

Section 5. Required offering of ovarian cancer testing. Ovarian cancer
literacy pamphlet to be provided to a patient. Section 6. Provides for
the effective date.

 
JUSTIFICATION:

Typically, the general CA125 misses more than half of all cancer cases
once a mass is found and primarily detects only when it is late stage,
in most cases too late. CA125 misses between 37-67% of ovarian cancer
cases in Black women. Black women have a much higher 5-year ovarian
cancer mortality rate of 62 percent. As with other cancers, it is best
to diagnose the disease in its early stages to best treat the cancer and
defeat the disease. Ovarian Cancer is more likely to be missed or miss
diagnosed due to symptoms that overlap with more benign conditions such
as endometriosis or due to diagnostic tests that were not created for
this cause being used.

Allowing and mandating screening for ovarian cancer yearly is necessary
to curtail the number of deaths that occur each year from ovarian
cancer. Ovarian cancer is a disease that mostly affects older women,
especially after menopause. As of 2022, an annual gynecological exam
does not test for ovarian cancer but covers cervical and other cancers.
The American Cancer Society states that in 2022, about 20,000 women will
receive a new diagnosis of ovarian cancer and about 13,000 women will
die from ovarian cancer. The ACA finds that if a woman has a family
member who has been diagnosed with ovarian cancer; they are now 25
percent more likely to get the disease; as the likelihood of having
ovarian cancer increases because of certain genes in one's DNA that are
passed on to offspring.

Screening tests and educating patients about ovarian cancer will serve
as great preventive measures to reduce ovarian cancer-related deaths.
In addition to the screening tests, educating patients through pamphlets
about ovarian cancer is another great preventative measure.  The more
educated the patient is, the more likely they are to notice if something
is wrong or has changed in their body, and it will prompt them to visit
their medical provider. This also helps patients who previously had
cancer or are more prone to getting it.

 
PRIOR LEGISLATIVE HISTORY:

2022: S8178 Referred to Insurance

 
FISCAL IMPLICATIONS:

None

 
EFFECTIVE DATE:
The act shall take effect on the thirtieth day after it shall become
law.

2023-S1187 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1187
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 10, 2023
                                ___________
 
 Introduced  by  Sens.  PERSAUD,  HOYLMAN-SIGAL, KENNEDY, PALUMBO -- read
   twice and ordered printed, and when printed to  be  committed  to  the
   Committee on Insurance
 
 AN  ACT  to  amend  the  insurance  law, the social services law and the
   public health law, in relation to requiring health insurance  policies
   to fully cover testing for ovarian cancer and requiring certain health
   care providers to offer annual testing for ovarian 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-c to read as follows:
   (11-C)  (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL
 OR MEDICAL CARE SHALL OFFER FULL COVERAGE FOR ANNUAL TESTING TO PATIENTS
 THAT ARE AT HIGH-RISK OF DEVELOPING OVARIAN CANCER  INCLUDING,  BUT  NOT
 LIMITED  TO, FDA-APPROVED TESTING, TRANSVAGINAL ULTRASOUND, PELVIC EXAM,
 AND OTHER EXAMS REGARDLESS IF PRESENTING SIGNS AND SYMPTOMS.
   (B) SUCH ADDITIONAL COVERAGE SHALL NOT BE SUBJECT  TO  ANNUAL  DEDUCT-
 IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 11-c to read as follows:
   (11-C) (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 HOSPITAL, SURGICAL OR MEDICAL CARE SHALL OFFER FULL  COVER-
 AGE FOR ANNUAL TESTING FOR INDIVIDUALS AT HIGH-RISK OF DEVELOPING OVARI-
 AN  CANCER INCLUDING, BUT NOT LIMITED TO, FDA-APPROVED TESTING, TRANSVA-
 GINAL ULTRASOUND, PELVIC EXAM  AND  OTHER EXAMS AVAILABLE  TO  THOSE  AT
 HIGH-RISK  OF  DEVELOPING  OVARIAN CANCER REGARDLESS IF PRESENTING SIGNS
 AND SYMPTOMS.
   (B) SUCH ADDITIONAL COVERAGE SHALL NOT BE SUBJECT  TO  ANNUAL  DEDUCT-
 IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02610-01-3
 S. 1187                             2

 
   §  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
 HOSPITAL,  SURGICAL OR MEDICAL CARE SHALL OFFER FULL COVERAGE FOR ANNUAL
 TESTING FOR  INDIVIDUALS  AT  HIGH-RISK  OF  DEVELOPING  OVARIAN  CANCER
 INCLUDING, BUT NOT LIMITED TO, FDA-APPROVED TESTING, TRANSVAGINAL ULTRA-
 SOUND,  PELVIC  EXAM  AND  OTHER  EXAMS  FOR INDIVIDUALS AT HIGH-RISK OF
 DEVELOPING OVARIAN CANCER REGARDLESS IF PRESENTING SIGNS OR SYMPTOMS.
   (2) SUCH ADDITIONAL COVERAGE SHALL NOT BE SUBJECT  TO  ANNUAL  DEDUCT-
 IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
   §  4.  Subdivision  2  of  section 365-a of the social services law is
 amended by adding a new paragraph (iii) to read as follows:
   (III) ANNUAL OVARIAN CANCER TESTING INCLUDING,  BUT  NOT  LIMITED  TO,
 FDA-APPROVED  TESTING,  PELVIC  EXAM, TRANSVAGINAL ULTRASOUND AND  OTHER
 EXAMS AVAILABLE TO THOSE AT RISK OR HIGH-RISK FOR CANCER  REGARDLESS  IF
 PRESENTING SIGNS AND SYMPTOMS.
   §  5.  The public health law is amended by adding a new section 2405-a
 to read as follows:
   § 2405-A. REQUIRED OFFERING OF OVARIAN CANCER TESTING.  1. HEALTH CARE
 PROVIDERS SUCH AS A PHYSICIAN, PHYSICIAN ASSISTANT, NURSE  PRACTITIONER,
 OR MIDWIFE PROVIDING PRIMARY CARE SHALL ASK SPECIFIC QUESTIONS TO DETER-
 MINE  IF  THERE  ARE  ANY  SIGNS  OR  SYMPTOMS THAT MAY INDICATE OVARIAN
 CANCER. ONCE SIGNS AND SYMPTOMS OF OVARIAN CANCER HAVE BEEN DETECTED, OR
 A PROVIDER IS SUSPICIOUS THE PATIENT HAS OVARIAN CANCER, OVARIAN  CANCER
 "TESTING"  MAY  THEN  BE PERFORMED, WHICH COULD ENCOMPASS A PELVIC EXAM,
 FDA-APPROVED TESTING,  TRANSVAGINAL  ULTRASOUND,  AND  OTHER  EXAMS  FOR
 OVARIAN CANCER. ADDITIONALLY, PROVIDERS SHALL AVAIL PATIENTS WITH OVARI-
 AN  CANCER  EDUCATION, INCLUDING, BUT NOT LIMITED TO, INFORMATION ON THE
 SIGNS AND SYMPTOMS OF OVARIAN CANCER AND PROVIDING THE  PATIENT  WITH  A
 COPY OF THE INFORMATIONAL PAMPHLET DEVELOPED AND SUPPLIED BY THE DEPART-
 MENT,  UNLESS  THE  HEALTH  CARE  PRACTITIONER  PROVIDING  SUCH SERVICES
 REASONABLY BELIEVES THAT: (A) THE INDIVIDUAL IS BEING TREATED FOR A LIFE
 THREATENING EMERGENCY; OR (B) THE INDIVIDUAL LACKS CAPACITY  TO  CONSENT
 TO OVARIAN CANCER TESTING.
   2. AS USED IN THIS SECTION, "PRIMARY CARE" MEANS THE MEDICAL FIELDS OF
 FAMILY  MEDICINE,  GENERAL  PEDIATRICS, PRIMARY CARE, INTERNAL MEDICINE,
 PRIMARY CARE OBSTETRICS, OR PRIMARY CARE GYNECOLOGY, WITHOUT  REGARD  TO
 BOARD CERTIFICATION.
   3.  THE OFFERING OF OVARIAN CANCER TESTING UNDER THIS SECTION SHALL BE
 CULTURALLY AND LINGUISTICALLY APPROPRIATE IN ACCORDANCE WITH  RULES  AND
 REGULATIONS PROMULGATED BY THE COMMISSIONER.
   4.  THE  DEPARTMENT  SHALL  DEVELOP INFORMATIONAL PAMPHLETS ON OVARIAN
 CANCER AND SUPPLY SUCH PAMPHLETS TO HEALTH SERVICE PROVIDERS.
   5. THIS SECTION SHALL NOT AFFECT THE SCOPE OF PRACTICE OF  ANY  HEALTH
 CARE  PRACTITIONER  OR  DIMINISH  ANY AUTHORITY OR LEGAL OR PROFESSIONAL
 OBLIGATION OF ANY HEALTH CARE PRACTITIONER TO OFFER OVARIAN CANCER TEST-
 ING OR TO PROVIDE SERVICES OR CARE FOR THE  SUBJECT  OF  OVARIAN  CANCER
 TESTING.
   §  6. This act shall take effect on the first of January next succeed-
 ing the date on which it shall have become a  law  and  shall  apply  to
 policies issued, reissued, renewed, modified or amended on or after such
 date.

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Senate Bill S1187

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Sponsored By

Roxanne J. Persaud