NY State Senate Bill 2023-S927

Senate Bill S927

2023-2024 Legislative Session

Requires health insurance policies to cover comprehensive genetic screening for ovarian and prostate cancers

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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
Jan 09, 2023	referred to insurance

co-Sponsors

2023-S927 (ACTIVE) - Details

See Assembly Version of this Bill:: A9075
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2015-2016: A291
2017-2018: A1807
2019-2020: S4768, A5727
2021-2022: S105, A425

2023-S927 (ACTIVE) - Summary

Requires health insurance policies to cover comprehensive genetic screening and FDA approved biomarker testing for ovarian and prostate cancers.

2023-S927 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S927

SPONSOR: PERSAUD
 
TITLE OF BILL:

An act to amend the insurance law, in relation to requiring health
insurance policies to fully cover comprehensive genetic testing and FDA
approved biomarker testing for ovarian and prostate cancers

 
PURPOSE:

Requires health insurance policies to cover comprehensive genetic
screening for ovarian and prostate cancers

 
SUMMARY OF PROVISIONS:

Section I states that this act shall be cited as the "Ana Lucia Act."

Section II Paragraph 11-a of subsection (i) of section 3216 law is
amended by adding a new subparagraph (C)(i) to provide additional full
coverage for comprehensive genetic testing and FDA-approved testing
based on family or person's history when recommended by a board-certi-

fied geneticist or a board-certified genetic counselor.

Section III Paragraph 11-a of subsection (1) of section 3221 of the
insurance law is amended by adding a new subparagraph (C) to provide
additional full coverage for the comprehensive genetic testing and FDA
approved testing based on family or person's history when recommended by
a board-certified geneticist or a board-certified genetic counselor.

Section IV Subsection (z-1) of section 4303 of the insurance law is
amended by adding a new paragraph 3(A) to provide additional full cover-
age for comprehensive genetic testing and FDA-approved testing based on
family or person's history when recommended by a board-certified geneti-
cist or a board-certified genetic counselor.

Section V provides for the effective date of the sixtieth day after it
shall become a law.

 
JUSTIFICATION:

This legislation mandates that insurance companies cover the costs of
genetic and FDA-approved biomarker testing for ovarian and prostate
cancer, which could lead to early detection, and in some cases, prevents
some of the most common and life-threatening cancers such as breast,
prostate, ovarian, colon, and lung cancers. According to the American
Cancer Society, 1 in 41 men will die from prostate cancer, hence why it
is "the second leading cause of cancer death in American men, behind
lung cancer." In 2021, there are approximately 248,530 new cases of
prostate cancer and roughly 34,130 deaths.

According to the National Center for Biotechnology Information, "ovarian
cancer is the ninth leading cause of cancer to women, but the fifth
leading cause of all cancer-related. deaths." In 2009, There were 21,550
new cases and 14,600 deaths were estimated. 1 in 78 American. women will
be diagnosed with ovarian cancer during their lifetime.

Ovarian cancer is difficult to detect, particularly in the early stage;
its symptoms mimic others such as bloating, pelvic or abdominal pain,
trouble eating or feeling full quickly, fatigue, upset stomach or heart-
burn, back pain, pain during sex, constipation, menstrual changes, feel-
ing the need to urinate instantly or often.  The ovaries are small,
shaped like almonds, located deep within the abdominal cavity; one on
each side of the uterus which makes it hard to test for ovarian cancer.
Currently, there is no blood " work to detect ovarian cancer.

Although we rely on the CA 125 to monitor women that are being treated
for ovarian cancer, it is not a helpful screening test for cancer. An
elevated CA 125 does not automatically mean one has cancer. A high level
of CA 125 can occur due to many non-cancerous conditions. For instance,
roughly of women with elevated CA 125 levels have ovarian cancer" Up to
20% of ovarian cancer patients do not have an elevated CA 125 MedicineN-
et).

 
LEGISLATIVE HISTORY:

S2021-2022 S105 A Referred to Insurance

2020:S105 Referred to Insurance

 
FISCAL IMPACT ON THE STATE:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect on the sixtieth day after it shall have
become law

2023-S927 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                    927
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                              January 9, 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,  in  relation  to  requiring  health
   insurance  policies  to  fully cover comprehensive genetic testing and
   FDA approved biomarker testing for ovarian and prostate cancers

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. This act shall be known and may be cited as the "Ana Lucia
 act".
   § 2. Paragraph 11-a of subsection (i) of section 3216 of the insurance
 law is amended by adding a new subparagraph (C) to read as follows:
   (C) (I) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
 HENSIVE GENETIC TESTING AND FDA APPROVED  TESTING  BASED  ON  FAMILY  OR
 PERSON'S  HISTORY FOR PROSTATIC AND OVARIAN CANCER WHEN RECOMMENDED BY A
 DOCTOR, A BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC  COUN-
 SELOR.  SUCH COVERAGE SHALL ALSO BE PROVIDED AFTER THE PATIENT'S INITIAL
 DIAGNOSIS.  PATIENTS  NEED  TO KNOW IF THEY CARRY THE GENETIC OR INHERI-
 TANCE MUTATION, WHICH CAN HELP TO DETERMINE POSSIBLE TREATMENTS. GENETIC
 SCREENING SHALL BE COVERED FOR PROSTATE  AND  OVARIAN  CANCER  PATIENTS'
 FAMILY  MEMBERS.  THE  GENETIC  RESULT  SHALL NOT BE USED AGAINST FAMILY
 MEMBERS THAT CARRY THE GENETIC OR  INHERITANCE  MUTATION  FOR  INSURANCE
 COVERAGE PURPOSES.
   (II) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
 BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND COINSURANCE BUT SHALL BE BORNE
 SOLELY BY THE INSURER.
   § 3. Paragraph 11-a of subsection (l) of section 3221 of the insurance
 law is amended by adding a new subparagraph (C) to read as follows:
   (C)(I) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR  COMPRE-
 HENSIVE  GENETIC  TESTING  AND  FDA  APPROVED TESTING BASED ON FAMILY OR
 PERSON'S HISTORY FOR PROSTATIC AND OVARIAN CANCER WHEN RECOMMENDED BY  A
 DOCTOR,  A BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUN-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD00460-01-3

 S. 927                              2
 
 SELOR.  SUCH COVERAGE SHALL ALSO BE PROVIDED AFTER THE PATIENT'S INITIAL
 DIAGNOSIS. PATIENTS NEED TO KNOW IF THEY CARRY THE  GENETIC  OR  INHERI-
 TANCE MUTATION, WHICH CAN HELP TO DETERMINE POSSIBLE TREATMENTS. GENETIC
 SCREENING  SHALL  BE  COVERED  FOR PROSTATE AND OVARIAN CANCER PATIENTS'
 FAMILY MEMBERS. THE GENETIC RESULT SHALL  NOT  BE  USED  AGAINST  FAMILY
 MEMBERS  THAT  CARRY  THE  GENETIC OR INHERITANCE MUTATION FOR INSURANCE
 COVERAGE PURPOSES.
   (II) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
 BE SUBJECT TO ANNUAL DEDUCTIBLES AND  COINSURANCE  BUT  SHALL  BE  BORNE
 SOLELY BY THE INSURER.
   §  4. Subsection (z-1) of section 4303 of the insurance law is amended
 by adding a new paragraph 3 to read as follows:
   (3)(A) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR  COMPRE-
 HENSIVE  GENETIC  TESTING  AND  FDA  APPROVED TESTING BASED ON FAMILY OR
 PERSON'S HISTORY FOR PROSTATIC AND OVARIAN CANCER WHEN RECOMMENDED BY  A
 DOCTOR,  A BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUN-
 SELOR.
   (B) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL  NOT
 BE  SUBJECT  TO  ANNUAL  DEDUCTIBLES  AND COINSURANCE BUT SHALL BE BORNE
 SOLELY BY THE INSURER.  SUCH COVERAGE SHALL ALSO BE PROVIDED  AFTER  THE
 PATIENT'S  INITIAL  DIAGNOSIS.  PATIENTS  NEED TO KNOW IF THEY CARRY THE
 GENETIC OR INHERITANCE MUTATION, WHICH CAN HELP  TO  DETERMINE  POSSIBLE
 TREATMENTS.  GENETIC SCREENING SHALL BE COVERED FOR PROSTATE AND OVARIAN
 CANCER PATIENTS' FAMILY MEMBERS. THE GENETIC RESULT SHALL  NOT  BE  USED
 AGAINST  FAMILY  MEMBERS  THAT CARRY THE GENETIC OR INHERITANCE MUTATION
 FOR INSURANCE COVERAGE PURPOSES.
   § 5. This act shall take effect on the sixtieth  day  after  it  shall
 have become a law and shall apply to all policies, contracts and certif-
 icates  issued,  renewed,  modified, altered or amended on or after such
 date.

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Senate Bill S927

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Sponsored By

Roxanne J. Persaud