NY State Senate Bill 2023-S4365

Senate Bill S4365

2023-2024 Legislative Session

Requires certain health insurance policies to provide coverage for diagnostic testing for ovarian cancer

download bill text pdf

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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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2024	referred to insurance
Feb 07, 2023	referred to insurance

co-Sponsors

2023-S4365 (ACTIVE) - Details

See Assembly Version of this Bill:: A4779
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: A2521
2011-2012: A3177
2013-2014: A4238
2015-2016: S4730, A917
2017-2018: S1162, A1745
2019-2020: S526, A3684
2021-2022: S4832, A1824

2023-S4365 (ACTIVE) - Summary

Provides that every health insurance policy which provides coverage for hospital, surgical or medical care shall provide coverage for the standard diagnostic testing for ovarian cancer upon the recommendation of a physician; provides that such standard diagnostic testing shall include a pelvic examination, a sonogram and a CA 125 blood test and related laboratory and diagnostic services.

2023-S4365 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S4365

SPONSOR: FERNANDEZ
 
TITLE OF BILL:

An act to amend the insurance law, in relation to health insurance
coverage for diagnostic testing for ovarian cancer

 
PURPOSE OR GENERAL IDEA OF BILL:

To require every health insurance policy that provides coverage for
hospital, surgical or medical care to provide coverage for diagnostic
testing for ovarian cancer.

 
SUMMARY OF PROVISIONS:

Section 1 amends subsection (i) of section 3216 of the insurance law by
adding a new paragraph 11-b to which requires every policy in this state
providing medical coverage to carry coverage for ovarian cancer testing
and screening.

Section 2 amends subsection (1) of section 3221 of the insurance law by

adding a new paragraph 11-b to which requires every insurer in this
state providing medical coverage to carry coverage for ovarian cancer
testing and screening.

Section 3 amends section 4303 of the insurance law by adding a new
subsection (ss) to require every hospital service corporation, medical
expenses indemnity corporation or health service corporation providing
medical coverage to carry coverage for ovarian cancer testing and
screening.

Section 4 sets forth the effective date.

 
JUSTIFICATION:

Ovarian cancer is the fifth most common cancer in women. According to
Memorial Sloan Kettering, one in 70 women will develop ovarian cancer in
her lifetime, and in 2008, more than 15,000 women died from it.  Early
detection and treatment are the keys to stopping this deadly disease.
While there is no existing screening test for ovarian cancer, diagnostic
tests are crucial for determining whether a patient experiencing symp-
toms has ovarian cancer. No woman should have to forgo or delay testing
because it is not covered by her insurer. This bill will ensure that all
insurers in New York State provide coverage for diagnostic testing for
ovarian cancer.

 
PRIOR LEGISLATIVE HISTORY:

2021-2022: S4832 / A1824

2019-2020: S526 / A3684

2017-2018: S1162 / A1745

2015-2016: S4730 / A917

 
FISCAL IMPLICATIONS:

TBD

 
EFFECTIVE DATE:
This act shall take effect on the first of January next succeeding the
date on which it shall have become a law and shall apply to all policies
issued, renewed, altered or modified on or after such effective date.

2023-S4365 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4365
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             February 7, 2023
                                ___________
 
 Introduced by Sen. FERNANDEZ -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN  ACT  to  amend  the  insurance  law, in relation to health insurance
   coverage for diagnostic 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 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, COVERAGE FOR DIAGNOSTIC  TESTING
 FOR OVARIAN CANCER, INCLUDING A PELVIC EXAMINATION, A SONOGRAM, A CA 125
 BLOOD TEST AND LABORATORY AND DIAGNOSTIC SERVICES PROVIDED IN CONNECTION
 WITH  EXAMINING  AND EVALUATING SUCH BLOOD TEST FOR WOMEN AGED FORTY AND
 OVER WITH ONE OR MORE FEMALE RELATIVES WITH A PRIOR HISTORY  OF  OVARIAN
 CANCER.
   (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-c to read as follows:
   (11-C) (A) EVERY INSURER WHICH DELIVERS OR ISSUES FOR DELIVERY IN THIS
 STATE  A  POLICY  WHICH PROVIDES MEDICAL COVERAGE THAT INCLUDES COVERAGE
 FOR PHYSICIAN SERVICES IN A PHYSICIAN'S OFFICE OR MAJOR MEDICAL OR SIMI-
 LAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE, UPON THE PRESCRIPTION  OF
 A HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE UNDER TITLE EIGHT
 OF  THE  EDUCATION  LAW,  COVERAGE  FOR  DIAGNOSTIC  TESTING FOR OVARIAN
 CANCER, INCLUDING A PELVIC EXAMINATION, A SONOGRAM, A CA 125 BLOOD  TEST
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08679-01-3

 S. 4365                             2
 
 AND LABORATORY AND DIAGNOSTIC SERVICES PROVIDED IN CONNECTION WITH EXAM-
 INING  AND EVALUATING SUCH BLOOD TEST FOR WOMEN AGED FORTY AND OVER WITH
 ONE OR MORE FEMALE RELATIVES WITH A PRIOR HISTORY OF OVARIAN CANCER.
   (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 (uu) to read as follows:
   (UU) (1) A HOSPITAL SERVICE  CORPORATION,  MEDICAL  EXPENSE  INDEMNITY
 CORPORATION  OR HEALTH SERVICE CORPORATION WHICH PROVIDES MEDICAL COVER-
 AGE THAT INCLUDES COVERAGE  FOR  PHYSICIAN  SERVICES  IN  A  PHYSICIAN'S
 OFFICE  OR  MAJOR  MEDICAL  OR SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL
 PROVIDE, UPON THE PRESCRIPTION OF A HEALTH CARE PROVIDER LEGALLY AUTHOR-
 IZED TO PRESCRIBE UNDER TITLE EIGHT OF THE EDUCATION LAW,  COVERAGE  FOR
 DIAGNOSTIC TESTING FOR OVARIAN CANCER, INCLUDING A PELVIC EXAMINATION, A
 SONOGRAM,  A  CA  125  BLOOD TEST AND LABORATORY AND DIAGNOSTIC SERVICES
 PROVIDED IN CONNECTION WITH EXAMINING AND EVALUATING SUCH BLOOD TEST FOR
 WOMEN AGED FORTY AND OVER WITH ONE OR MORE FEMALE RELATIVES WITH A PRIOR
 HISTORY OF OVARIAN CANCER.
   (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 and shall apply to all
 policies issued, renewed, altered or modified on or after such effective
 date.

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Senate Bill S4365

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Nathalia Fernandez