S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  1916

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 9, 2013
                               ___________

Introduced  by  M.  of  A.  ORTIZ, JACOBS, COOK, COLTON, CLARK, GUNTHER,
  PEOPLES-STOKES,  CAMARA,  MILLMAN,  BOYLAND,  CAHILL,  ENGLEBRIGHT  --
  Multi-Sponsored  by -- M. of A.  BRENNAN, FARRELL, GOTTFRIED, LUPARDO,
  RIVERA, WEISENBERG -- read once  and  referred  to  the  Committee  on
  Insurance

AN ACT to amend the insurance law, in relation to providing coverage for
  surveillance tests 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 30 to read as follows:
  (30)  EVERY  POLICY  THAT  PROVIDES  MEDICAL, MAJOR-MEDICAL OR SIMILAR
COMPREHENSIVE-TYPE COVERAGE  SHALL  PROVIDE  COVERAGE  FOR  SURVEILLANCE
TESTS  FOR  OVARIAN  CANCER  FOR  AN  INSURED WHO IS AT RISK FOR OVARIAN
CANCER. (A) FOR PURPOSES OF THIS SUBSECTION, AN INSURED IS DEEMED TO  BE
AT RISK IF:
  (I) SHE HAS A FAMILY HISTORY OF:
  1. ONE OR MORE FIRST-DEGREE RELATIVE WITH OVARIAN CANCER;
  2. THREE OR MORE FEMALE RELATIVES WITH BREAST CANCER; OR
  3. NONPOLYPOSIS COLORECTAL CANCER; OR
  (II) SHE TESTS POSITIVE FOR BRCA1 OR BRCA2 MUTATIONS.
  (B)  FOR  PURPOSES  OF THIS SUBSECTION, SURVEILLANCE TESTS FOR OVARIAN
CANCER SHALL MEAN ANNUAL SCREENING FOR OVARIAN CANCER USING:
  (I) CA-125 SERUM TUMOR MARKER TESTING;
  (II) TRANSVAGINAL ULTRASOUND; AND
  (III) PELVIC EXAMINATION.
  S 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 19 to read as follows:
  (19) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
THIS STATE WHICH PROVIDES HOSPITAL, SURGICAL OR MEDICAL  COVERAGE  SHALL

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
              

                                                           LBD04283-01-3

A. 1916                             2

INCLUDE  COVERAGE  FOR  SURVEILLANCE  TESTS  FOR  OVARIAN  CANCER FOR AN
INSURED WHO IS AT RISK FOR OVARIAN CANCER.  (A)  FOR  PURPOSES  OF  THIS
SUBSECTION, AN INSURED IS DEEMED TO BE AT RISK IF:
  (I) SHE HAS A FAMILY HISTORY OF:
  1. ONE OR MORE FIRST-DEGREE RELATIVE WITH OVARIAN CANCER;
  2. THREE OR MORE FEMALE RELATIVES WITH BREAST CANCER; OR
  3. NONPOLYPOSIS COLORECTAL CANCER; OR
  (II) SHE TESTS POSITIVE FOR BRCA1 OR BRCA2 MUTATIONS.
  (B)  FOR  PURPOSES  OF THIS SUBSECTION, SURVEILLANCE TESTS FOR OVARIAN
CANCER SHALL MEAN ANNUAL SCREENING FOR OVARIAN CANCER USING:
  (I) CA-125 SERUM TUMOR MARKER TESTING;
  (II) TRANSVAGINAL ULTRASOUND; AND
  (III) PELVIC EXAMINATION.
  S 3. Section 4303 of the insurance law is  amended  by  adding  a  new
subsection (jj) to read as follows:
  (JJ)  A HEALTH SERVICE CORPORATION OR MEDICAL EXPENSE INDEMNITY CORPO-
RATION   WHICH    PROVIDES    MEDICAL,    MAJOR-MEDICAL    OR    SIMILAR
COMPREHENSIVE-TYPE COVERAGE MUST PROVIDE COVERAGE FOR SURVEILLANCE TESTS
FOR OVARIAN CANCER FOR AN INSURED WHO IS AT RISK FOR OVARIAN CANCER. (1)
FOR PURPOSES OF THIS SUBSECTION, AN INSURED IS DEEMED TO BE AT RISK IF:
  (A) SHE HAS A FAMILY HISTORY OF:
  (I) ONE OR MORE FIRST-DEGREE RELATIVE WITH OVARIAN CANCER;
  (II) THREE OR MORE FEMALE RELATIVES WITH BREAST CANCER; OR
  (III) NONPOLYPOSIS COLORECTAL CANCER; OR
  (B) SHE TESTS POSITIVE FOR BRCA1 OR BRCA2 MUTATIONS.
  (2)  FOR  PURPOSES  OF THIS SUBSECTION, SURVEILLANCE TESTS FOR OVARIAN
CANCER SHALL MEAN ANNUAL SCREENING FOR OVARIAN CANCER USING:
  (A) CA-125 SERUM TUMOR MARKER TESTING;
  (B) TRANSVAGINAL ULTRASOUND; AND
  (C) PELVIC EXAMINATION.
  S 4. This act shall take effect immediately and  shall  apply  to  any
policy issued, renewed, or modified after such effective date.