NY State Senate Bill 2023-S9431

Senate Bill S9431

2023-2024 Legislative Session

Provides for insurance coverage of comprehensive annual medical examinations for firefighters

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 15, 2024	referred to insurance

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2023-S9431 (ACTIVE) - Details

See Assembly Version of this Bill:: A1403
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S9061
2021-2022: S3942, A8230

2023-S9431 (ACTIVE) - Summary

Provides for insurance coverage of comprehensive annual medical examinations for firefighters due to their increased risk for cancer and cancer-related diseases.

2023-S9431 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S9431

SPONSOR: WEBB
 
TITLE OF BILL:

An act to amend the insurance law, in relation to insurance coverage of
comprehensive annual medical examinations for firefighters

 
PURPOSE:

This legislation amends the insurance law to mandate that insurance
policies for firefighters include a number of screenings and early
detection tests due to their increased risk for cancer and cancer-relat-
ed disease.

 
SUMMARY OF PROVISIONS:

The legislation would amend subsection (i) of section 3216 of the insur-
ance law, subsection (1) of section 3221 of the insurance law, and
section 4303 of the insurance law to require that every policy that
provides medical, major medical, or similar comprehensive coverage for
firefighters includes:

1. Detailed Symptom Health History: headaches, skin rashes, intestinal
or respiratory symptoms, weakness, and cognitive dysfunction.

2. Physical Exam: a complete hand-on head-to-toe physical should be
performed. The main systems that should be reviewed are cardiovascular,
skin, thyroid, mouth, pulmonary, intestinal, breast, testes, urinary,
lymph nodes, neurological, and musculoskeletal.

3. Vital signs and body measures: blood pressure, oxygen saturation
(pOx), heart and respiratory rate, weight, height, body fat percentage
should be tested and recorded.

4. Laboratory assessments including:

a. Blood tests- CMP, CBC with differential, lipid panel, TSH, hCRP, and
HbAlc.

b. Urinalysis for pH, glucose, ketones, protein, blood, and bilirubin,
and microscopic assessment for WBC, RBC, WBC casts, RBC casts, and crys-
tals.

c. Serum and urine immunofixation

d. Urinalysis and CMP to detect early changes in kidney and bladder
function.

e. Spirometry provides a baseline and annual pulmonary function testing.

5. Cancer Screenings including: digital rectal exam for men with pros-
tate-specific antigen (PSA); cervical exam with PAP and breast exam for
women; FIT testing.

6. Colonoscopy at 45 years or earlier depending on family history.

7. Mammogram at 40 or earlier depending on family history.

8. Low Dose CT: depending on age, smoking history, FEV I, family history
of lung cancer, obstructive lung disease, history of pneumonia.

9. Chest x-ray every 5 years.

10. Stress EKG with VO2 value calculated.

11. Any additional illnesses as determined necessary by the Commissioner
of Health Section four establishes the effective date.

 
JUSTIFICATION:

This bill would require that insurance policies for firefighters include
a number of screenings and early detection tests due to their increased
risk for cancer and cancer-related disease. It is known that firefight-
ers face unique occupational health risks in the line of duty. Years of
research have shown that the health risks for firefighters are multifac-
torial and include exposures from several aspects of their work environ-
ment. Firefighters are not only at higher risk for cancers but also
cardiac-related death and coronary artery disease.

Chronic exposures to heat, smoke, and toxic flame retardants through
inhalation, ingestion, and skin absorption put firefighters at risk for
many cancers. The National Institute for Occupational Safety and Health
(NIOSH) performed a multi-year study of nearly 30,000 firefighters to
better understand the potential link between firefighting and cancer.
Exposure to aerosolized chemicals like benzene, asbestos, polycyclic
aromatic hydrocarbons (PAH), formaldehyde, diesel exhaust, and new
building materials with undefined chemicals creates special risks. The
firefighters studied showed higher rates of certain types of cancer than
the general U.S.  population.

In a study conducted by Roswell Park Comprehensive Cancer Center in
Buffalo, in coordination with 100 firefighter participants from 2 fire-
houses, the research found that even in fires with low smoke intensity,
firefighters were just as exposed to appreciable levels of toxic materi-
als. Exposure included carbon monoxide, benzene, aldehydes, and hydrogen
cyanide Exposure to these chemicals and/or any number of carcinogenic
substances puts firefighters at elevated risk for diseases less common
among other professions. This legislation would mandate insurance compa-
nies to pay for a wide variety of screenings and tests at these younger
ages for firefighters due to their increased risks. This legislation
will save the lives of firefighters throughout New York State.

 
LEGISLATIVE HISTORY:

2021-22: S.3942B/A.8230A FISCAL

 
IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
Immediately.

2023-S9431 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9431
 
                             I N  S E N A T E
 
                               May 15, 2024
                                ___________
 
 Introduced  by  Sen.  WEBB  --  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 insurance coverage  of
   comprehensive annual medical examinations for firefighters
 
   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 39 to read as follows:
   (39)(A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
 COMPREHENSIVE-TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE FOR COMPREHENSIVE
 ANNUAL MEDICAL EXAMS FOR INSURED INDIVIDUALS WHO ARE FIREFIGHTERS.  SUCH
 COMPREHENSIVE ANNUAL MEDICAL EXAM COVERAGE SHALL INCLUDE:
   (I)  A DETAILED SYMPTOM HEALTH HISTORY INCLUDING HEADACHES, SKIN RASH-
 ES, INTESTINAL OR RESPIRATORY SYMPTOMS, WEAKNESS, AND COGNITIVE DYSFUNC-
 TION;
   (II) AN  IN  PERSON  PHYSICAL  EXAM  INCLUDING  CARDIOVASCULAR,  SKIN,
 THYROID,  MOUTH,  PULMONARY, INTESTINAL, URINARY, LYMPH NODE, NEUROLOGI-
 CAL, MUSCULOSKELETAL, BREAST AND TESTES, AS APPLICABLE, EXAMINATION;
   (III) VITAL SIGNS AND BODY  MEASURES  TESTED  AND  RECORDED  INCLUDING
 BLOOD  PRESSURE,  OXYGEN SATURATION, HEART AND RESPIRATORY RATE, WEIGHT,
 HEIGHT AND BODY FAT PERCENTAGE;
   (IV) LABORATORY ASSESSMENTS INCLUDING:
   A. COMPREHENSIVE METABOLIC PANEL, COMPLETE BLOOD COUNT WITH  DIFFEREN-
 TIAL, LIPID PANEL, THYROID STIMULATING HORMONE, HIGH-SENSITIVITY C-REAC-
 TIVE PROTEIN, AND HEMOGLOBIN A1C BLOOD TESTS; AND
   B.  URINALYSIS FOR PH, GLUCOSE, KETONES, PROTEIN, BLOOD AND BILIRUBIN,
 AND MICROSCOPIC ASSESSMENT FOR WHITE BLOOD CELLS, RED BLOOD CELLS, WHITE
 BLOOD CELL CASTS, RED BLOOD CELL CASTS, AND CRYSTALS;
   (V) SPIROMETRY;
   (VI) CANCER SCREENING, INCLUDING, DIGITAL RECTAL EXAM FOR  INDIVIDUALS
 WITH  PROSTATE-SPECIFIC  ANTIGEN,  CERVICAL  EXAM  WITH PAP TEST, BREAST
 EXAM, RESPIRATOR FIT TEST, COLONOSCOPIES BEGINNING AT  FORTY-FIVE  YEARS
 OF  AGE  OR EARLIER DEPENDING ON FAMILY HISTORY, MAMMOGRAMS BEGINNING AT
 AGE FORTY OR EARLIER DEPENDING ON FAMILY HISTORY, AND LOW DOSE  COMPUTED
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.

                                                            LBD05695-01-3
 S. 9431                             2
 
 TOMOGRAPHY  DEPENDING  ON AGE, SMOKING HISTORY, FORCED EXPIRATORY VOLUME
 (FEV1), FAMILY HISTORY OF LUNG  CANCER,  OBSTRUCTIVE  LUNG  DISEASE  AND
 HISTORY OF PNEUMONIA; AND
   (VII)  A  STRESS  ELECTROCARDIOGRAM  WITH MAXIMAL OXYGEN UPTAKE CALCU-
 LATED.
   (B) NOTWITHSTANDING THE REQUIREMENTS FOR COMPREHENSIVE ANNUAL  MEDICAL
 EXAM  COVERAGE  PURSUANT  TO  SUBPARAGRAPH  (A)  OF THIS PARAGRAPH, SUCH
 COVERAGE SHALL ADDITIONALLY INCLUDE A CHEST X-RAY EVERY FIVE  YEARS  AND
 ANY  ADDITIONAL  TESTING  DETERMINED  NECESSARY  BY  THE COMMISSIONER OF
 HEALTH.
   (C) AN INSURED SHALL IDENTIFY HIS OR HER PROFESSION AS  A  FIREFIGHTER
 AND YEARS OF SERVICE TO HIS OR HER PRIMARY CARE PROVIDER TO RECEIVE SUCH
 COMPREHENSIVE ANNUAL MEDICAL EXAMINATION PURSUANT TO THIS PARAGRAPH.
   (D)  AS  USED IN THIS PARAGRAPH THE TERM "FIREFIGHTER" MEANS ANY FIRE-
 FIGHTER REGULARLY EMPLOYED BY A FIRE DEPARTMENT OF ANY  MUNICIPALITY  IN
 THE STATE.
   § 2. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 22 to read as follows:
   (22)(A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMILAR
 COMPREHENSIVE-TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE FOR COMPREHENSIVE
 ANNUAL MEDICAL EXAMS FOR INSURED INDIVIDUALS WHO ARE FIREFIGHTERS.  SUCH
 COMPREHENSIVE ANNUAL MEDICAL EXAM COVERAGE SHALL INCLUDE:
   (I)  A DETAILED SYMPTOM HEALTH HISTORY INCLUDING HEADACHES, SKIN RASH-
 ES, INTESTINAL OR RESPIRATORY SYMPTOMS, WEAKNESS, AND COGNITIVE DYSFUNC-
 TION;
   (II) AN  IN  PERSON  PHYSICAL  EXAM  INCLUDING  CARDIOVASCULAR,  SKIN,
 THYROID,  MOUTH,  PULMONARY, INTESTINAL, URINARY, LYMPH NODE, NEUROLOGI-
 CAL, MUSCULOSKELETAL, BREAST AND TESTES, AS APPLICABLE, EXAMINATION;
   (III) VITAL SIGNS AND BODY  MEASURES  TESTED  AND  RECORDED  INCLUDING
 BLOOD  PRESSURE,  OXYGEN SATURATION, HEART AND RESPIRATORY RATE, WEIGHT,
 HEIGHT AND BODY FAT PERCENTAGE;
   (IV) LABORATORY ASSESSMENTS INCLUDING:
   A. COMPREHENSIVE METABOLIC PANEL, COMPLETE BLOOD COUNT WITH  DIFFEREN-
 TIAL, LIPID PANEL, THYROID STIMULATING HORMONE, HIGH-SENSITIVITY C-REAC-
 TIVE PROTEIN, AND HEMOGLOBIN A1C BLOOD TESTS; AND
   B.  URINALYSIS FOR PH, GLUCOSE, KETONES, PROTEIN, BLOOD AND BILIRUBIN,
 AND MICROSCOPIC ASSESSMENT FOR WHITE BLOOD CELLS, RED BLOOD CELLS, WHITE
 BLOOD CELL CASTS, RED BLOOD CELL CASTS, AND CRYSTALS;
   (V) SPIROMETRY;
   (VI) CANCER SCREENING, INCLUDING, DIGITAL RECTAL EXAM FOR  INDIVIDUALS
 WITH  PROSTATE-SPECIFIC  ANTIGEN,  CERVICAL  EXAM  WITH PAP TEST, BREAST
 EXAM, RESPIRATOR FIT TEST, COLONOSCOPIES BEGINNING AT  FORTY-FIVE  YEARS
 OF  AGE  OR EARLIER DEPENDING ON FAMILY HISTORY, MAMMOGRAMS BEGINNING AT
 AGE FORTY OR EARLIER DEPENDING ON FAMILY HISTORY, AND LOW DOSE  COMPUTED
 TOMOGRAPHY  DEPENDING  ON AGE, SMOKING HISTORY, FORCED EXPIRATORY VOLUME
 (FEV1), FAMILY HISTORY OF LUNG  CANCER,  OBSTRUCTIVE  LUNG  DISEASE  AND
 HISTORY OF PNEUMONIA; AND
   (VII)  A  STRESS  ELECTROCARDIOGRAM  WITH MAXIMAL OXYGEN UPTAKE CALCU-
 LATED.
   (B) NOTWITHSTANDING THE REQUIREMENTS FOR COMPREHENSIVE ANNUAL  MEDICAL
 EXAM  COVERAGE  PURSUANT  TO  SUBPARAGRAPH  (A)  OF THIS PARAGRAPH, SUCH
 COVERAGE SHALL ADDITIONALLY INCLUDE A CHEST X-RAY EVERY FIVE  YEARS  AND
 ANY  ADDITIONAL  TESTING  DETERMINED  NECESSARY  BY  THE COMMISSIONER OF
 HEALTH.
 S. 9431                             3
 
   (C) AN INSURED SHALL IDENTIFY HIS OR HER PROFESSION AS  A  FIREFIGHTER
 AND YEARS OF SERVICE TO HIS OR HER PRIMARY CARE PROVIDER TO RECEIVE SUCH
 COMPREHENSIVE ANNUAL MEDICAL EXAMINATION PURSUANT TO THIS PARAGRAPH.
   (D)  AS  USED IN THIS PARAGRAPH THE TERM "FIREFIGHTER" MEANS ANY FIRE-
 FIGHTER REGULARLY EMPLOYED BY A FIRE DEPARTMENT OF ANY  MUNICIPALITY  IN
 THE STATE.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (l-3) to read as follows:
   (L-3)(A) EVERY CONTRACT WHICH  PROVIDES  MEDICAL,  MAJOR  MEDICAL,  OR
 SIMILAR  COMPREHENSIVE-TYPE  COVERAGE SHALL PROVIDE COVERAGE FOR COMPRE-
 HENSIVE ANNUAL MEDICAL EXAMS FOR INSURED INDIVIDUALS WHO ARE  FIREFIGHT-
 ERS. SUCH COMPREHENSIVE ANNUAL MEDICAL EXAM COVERAGE SHALL INCLUDE:
   (I)  A DETAILED SYMPTOM HEALTH HISTORY INCLUDING HEADACHES, SKIN RASH-
 ES, INTESTINAL OR RESPIRATORY SYMPTOMS, WEAKNESS, AND COGNITIVE DYSFUNC-
 TION;
   (II) AN  IN  PERSON  PHYSICAL  EXAM  INCLUDING  CARDIOVASCULAR,  SKIN,
 THYROID,  MOUTH,  PULMONARY, INTESTINAL, URINARY, LYMPH NODE, NEUROLOGI-
 CAL, MUSCULOSKELETAL, BREAST AND TESTES, AS APPLICABLE, EXAMINATION;
   (III) VITAL SIGNS AND BODY  MEASURES  TESTED  AND  RECORDED  INCLUDING
 BLOOD  PRESSURE,  OXYGEN SATURATION, HEART AND RESPIRATORY RATE, WEIGHT,
 HEIGHT AND BODY FAT PERCENTAGE;
   (IV) LABORATORY ASSESSMENTS INCLUDING:
   A. COMPREHENSIVE METABOLIC PANEL, COMPLETE BLOOD COUNT WITH  DIFFEREN-
 TIAL, LIPID PANEL, THYROID STIMULATING HORMONE, HIGH-SENSITIVITY C-REAC-
 TIVE PROTEIN, AND HEMOGLOBIN A1C BLOOD TESTS; AND
   B.  URINALYSIS FOR PH, GLUCOSE, KETONES, PROTEIN, BLOOD AND BILIRUBIN,
 AND MICROSCOPIC ASSESSMENT FOR WHITE BLOOD CELLS, RED BLOOD CELLS, WHITE
 BLOOD CELL CASTS, RED BLOOD CELL CASTS, AND CRYSTALS;
   (V) SPIROMETRY;
   (VI) CANCER SCREENING, INCLUDING, DIGITAL RECTAL EXAM FOR  INDIVIDUALS
 WITH  PROSTATE-SPECIFIC  ANTIGEN,  CERVICAL  EXAM  WITH PAP TEST, BREAST
 EXAM, RESPIRATOR FIT TEST, COLONOSCOPIES BEGINNING AT  FORTY-FIVE  YEARS
 OF  AGE  OR EARLIER DEPENDING ON FAMILY HISTORY, MAMMOGRAMS BEGINNING AT
 AGE FORTY OR EARLIER DEPENDING ON FAMILY HISTORY, AND LOW DOSE  COMPUTED
 TOMOGRAPHY  DEPENDING  ON AGE, SMOKING HISTORY, FORCED EXPIRATORY VOLUME
 (FEV1), FAMILY HISTORY OF LUNG  CANCER,  OBSTRUCTIVE  LUNG  DISEASE  AND
 HISTORY OF PNEUMONIA; AND
   (VII)  A  STRESS  ELECTROCARDIOGRAM  WITH MAXIMAL OXYGEN UPTAKE CALCU-
 LATED.
   (B) NOTWITHSTANDING THE REQUIREMENTS FOR COMPREHENSIVE ANNUAL  MEDICAL
 EXAM  COVERAGE PURSUANT TO PARAGRAPH (A) OF THIS SUBSECTION, SUCH COVER-
 AGE SHALL ADDITIONALLY INCLUDE A CHEST X-RAY EVERY FIVE  YEARS  AND  ANY
 ADDITIONAL TESTING DETERMINED NECESSARY BY THE COMMISSIONER OF HEALTH.
   (C)  AN  INSURED SHALL IDENTIFY HIS OR HER PROFESSION AS A FIREFIGHTER
 AND YEARS OF SERVICE TO HIS OR HER PRIMARY CARE PROVIDER TO RECEIVE SUCH
 COMPREHENSIVE ANNUAL MEDICAL EXAMINATION PURSUANT TO THIS SUBSECTION.
   (D) AS USED IN THIS SUBSECTION THE TERM "FIREFIGHTER" MEANS ANY  FIRE-
 FIGHTER  REGULARLY  EMPLOYED BY A FIRE DEPARTMENT OF ANY MUNICIPALITY IN
 THE STATE.
   § 4. This act shall take effect immediately and shall apply  to  poli-
 cies  and contracts issued, renewed, modified, altered or amended on and
 after such date.

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Senate Bill S9431

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Sponsored By

Lea Webb