NY State Senate Bill 2023-S5134

Senate Bill S5134

2023-2024 Legislative Session

Requires health insurance policies to fully cover multi-marker testing related to certain patients

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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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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 03, 2024	referred to insurance
Feb 23, 2023	referred to insurance

co-Sponsors

2023-S5134 (ACTIVE) - Details

See Assembly Version of this Bill:: A6186
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L

2023-S5134 (ACTIVE) - Summary

Requires health insurance policies to fully cover multi-marker testing related to ovarian cancer to patients which have been diagnosed with an ovarian adnexal mass.

2023-S5134 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S5134

SPONSOR: PERSAUD
 
TITLE OF BILL:

An act to amend the insurance law and the social services law, in
relation to requiring health insurance policies to fully cover multi-
marker testing related to ovarian cancer to patients which have been
diagnosed with an ovarian adnexal mass

 
PURPOSE:

Requires health insurance policies to fully cover multi-marker testing
related to certain patients.

 
SUMMARY OF PROVISIONS:

Section I Subsection (i) of section 3216 of the insurance law is amended
by adding a new paragraph 11-c that requires policies that provide
coverage for hospital, surgical or medical care to also provide full
coverage for multimarker testing related to ovarian cancer to patients
who have been diagnosed with an ovarian adnexal mass.

Subsection (I) of section 3221 of the insurance law is amended by adding
a new paragraph 11-c that requires insurers delivering a group or blan-
ket policy or issuing a group or blanket policy in this state covering
for hospital, surgical or medical care to also provide full coverage for
multimarker testing related to ovarian cancer to patients who have been
diagnosed with an ovarian adnexal mass.

A medical expense indemnity corporations, hospital service corporations,
and health service corporations that provides coverage for hospital,
surgical or medical care to also provide full coverage for multimarker
testing related to ovarian cancer to patients who have been diagnosed
with an ovarian adnexal mass.

Subdivision 2 of section 365-a of the social services law is amended by
adding a new paragraph (kk) that amends definitive language.

 
JUSTIFICATION:

The American Cancer Society finds that ovarian cancer ranks fifth in
cancer deaths among women. The gold standard in ovarian detection, the
cancer antigen-125 (CA-125) blood test, is useful in treating women
known to have the condition but not for screening purposes.  Research
shows that including additional biomarkers in diagnostic screening
improves the early detection of ovarian cancer with a diagnostic power
of 86% sensitivity (SN) for early-stage and 93% SN for late-stage ovari-
an cancer at 98% specificity (SP) (Yurkovetsky et. al., 2010).

Providing full coverage for multi-marker testing related to ovarian
cancer can improve the early detection and treatment outcomes for
patients who are diagnosed with this condition. They can also cut unnec-
essary spending by $0.05 PMPM (per month per member) (Brodsky et. al.
2017) by preventing false-diagnosis and over-treatment for this condi-
tion (Wald et. al., 2022).

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPACT ON THE STATE:

To be determined.

 
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 policies
issued, reissued, renewed, modified or amended on or after such date.

2023-S5134 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5134
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             February 23, 2023
                                ___________
 
 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 to fully cover multi-
   marker testing related to ovarian cancer to patients which  have  been
   diagnosed with an ovarian adnexal mass
 
   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  MULTI-MARKER  TESTING
 RELATED  TO OVARIAN CANCER TO PATIENTS WHICH HAVE BEEN DIAGNOSED WITH AN
 OVARIAN ADNEXAL MASS.
   (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 MULTI-MARKER TESTING RELATED TO OVARIAN CANCER TO PATIENTS WHICH
 HAVE BEEN DIAGNOSED WITH AN OVARIAN ADNEXAL MASS.
   (B)  SUCH  ADDITIONAL  COVERAGE SHALL NOT BE SUBJECT TO ANNUAL DEDUCT-
 IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
   § 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 MULTI-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07245-01-3
 S. 5134                             2

 
 MARKER TESTING RELATED TO OVARIAN CANCER TO  PATIENTS  WHICH  HAVE  BEEN
 DIAGNOSED WITH AN OVARIAN ADNEXAL MASS.
   (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 (kk) to read as follows:
   (KK)  MULTI-MARKER TESTING RELATED TO OVARIAN CANCER TO PATIENTS WHICH
 HAVE BEEN DIAGNOSED WITH AN OVARIAN ADNEXAL MASS.
   § 5. 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 S5134

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Sponsored By

Roxanne J. Persaud