NY State Senate Bill 2021-S8961

Senate Bill S8961

2021-2022 Legislative Session

Requires insurance companies to reimburse all health care practitioners at the same rate for cervical cytology screening

download bill text pdf

Archive: Last 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 02, 2022	referred to insurance

2021-S8961 (ACTIVE) - Details

See Assembly Version of this Bill:: A10257
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L; amd §364-j, Soc Serv L; add Art 2 Title 6 §266-a, Pub Health L
Versions Introduced in 2023-2024 Legislative Session:: S2017

2021-S8961 (ACTIVE) - Summary

Requires insurance companies to reimburse all health care practitioners at the same rate for cervical cytology screening, including the preparation of a Pap smear; prohibits health care practitioners from refusing to provide a Pap smear during a regular annual checkup if such patient has not had a Pap smear done in the preceding twelve months.

2021-S8961 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S8961

SPONSOR: CLEARE
 
TITLE OF BILL:

An act to amend the insurance law, the social services law and the
public health law, in relation to requiring insurance companies to reim-
burse all health care practitioners at the same rate for cervical cytol-
ogy screening

 
PURPOSE OR GENERAL IDEA OF BILL:

To improve health care access and reduce health care disparities faced
by women who otherwise would need to see two different doctors to have
annual cervical cancer screenings.

 
SUMMARY OF SPECIFIC PROVISIONS:

Section 1. Subparagraph (B) of paragraph 15 of subsection (i) of section
3216 of the insurance law, as amended by chapter 219 of the laws of
2011, is amended to read as follows:

An insurer shall provide the same rate of reimbursement for cervical
cytology screening whether such screening is performed by a licensed
health care practitioner or by a provider of obstetrical and/or gyneco-
logic services.

Section 2: Subparagraph (B) of paragraph 14 of subsection (I) of section
3221 of the insurance law, as amended by chapter 219 of the laws of
2011, is amended to read as follows:

An insurer shall provide the same rate of reimbursement for cervical
cytology screening whether such screening is performed by a licensed
health care practitioner or by a provider of obstetrical and/or gyneco-
logic services.

Section 3: Paragraph 2 of subsection (t) of section 4303 of the insur-
ance law, as amended by chapter 219 of the laws of 2011, is amended to
read as follows:

An insurer shall provide the same rate of reimbursement for cervical
cytology screening whether such screening is performed by a licensed
health care practitioner or by a provider of obstetrical and/or gyneco-
logic services.

Section 4: Section 364-j is amended by adding a new subdivision 18-a to
read as follows:

Managed care providers shall be reimbursed at the same rate for cervical
cytology screening, including but not limited to the preparation of a
Pap smear, whether such screening is performed by a primary care practi-
tioner or by a medical services provider of obstetrical and/or gyneco-
logic services.

Section 5: Title 6 of article 2 of the public health law, as added by
chapter 342 of the laws of 2014, is amended by adding a new section
266-a to read as follows:


Cervical cytology screening. Notwithstanding any provision of law to the
contrary, a primary care practitioner shall not refuse to perform cervi-
cal cytology screening, including but not limited to the preparation of
a Pap smear, during a patient's regular annual checkup or for new
patients who have not had a Pap smear done by a primary care practition-
er or by a provider of obstetrical and/or gynecologic services within
the preceding twelve months.

Section 6: This act shall take effect on the one hundred eightieth day
after it shall have become a law; Effective immediately, the addition,
amendment and/or repeal of any rule or regulation necessary for the
implementation of this act on its effective date are authorized to be
made and completed on or before such effective date.

 
JUSTIFICATION:

Having women visit two doctors to get their complete annual physical
exam is a clear example of institutional barriers to wellness that have
been put in place by bad public policy. This is currently the case for
women who must visit their primary doctor and then make a second
appointment to see an OBGYN to be screened for cervical cancer.

For many women, taking two days off from work instead of just one
creates complications with their jobs. Many low-wage workers have limit-
ed time off allowed by their employers, others with limited or no health
insurance find that the current practice of seeing two doctors for
complete health screening is costly.

Over a decade ago, New York State decided to require that only OBGYNs
would be reimbursed for pap smear exams. Previously, general practice
doctors could and would do the exams at yearly physical exams of their
patients. The practice has endured causing countless women to forgo
these life saving cancer screenings and an unknown number have lost
their lives by forgoing the two doctor visits to get the full annual
health screening, had cancer and never knew it till it was too late for
modern medicine to save their lives.

This legislation aims to revert the practice of allowing general MDs to
perform the pap smear to detect cervical cancer by setting the same
insurance (private and public) reimbursement rate for the exam.  This
legislation also prevents primary care physicians from denying such
screenings when the reimbursement rate is equalized.

Ensuring proper access and lower health care disparities in women is a
matter of dismantling bad public policy. This legislation aims to accom-
plish exactly this.

 
PRIOR LEGISLATIVE HISTORY:

New legislation

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect

2021-S8961 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8961
 
                             I N  S E N A T E
 
                                May 2, 2022
                                ___________
 
 Introduced  by  Sen.  CLEARE -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law,  the  social  services  law  and  the
   public  health  law,  in  relation to requiring insurance companies to
   reimburse all health care practitioners at the same rate for  cervical
   cytology screening

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraph (B) of  paragraph  15  of  subsection  (i)  of
 section 3216 of the insurance law, as amended by chapter 219 of the laws
 of 2011, is amended to read as follows:
   (B)  For  purposes  of  subparagraphs  (A)  and (C) of this paragraph,
 cervical cytology screening shall include an annual pelvic  examination,
 collection and preparation of a Pap smear, and laboratory and diagnostic
 services  provided  in  connection with examining and evaluating the Pap
 smear. AN INSURER SHALL PROVIDE  THE  SAME  RATE  OF  REIMBURSEMENT  FOR
 CERVICAL  CYTOLOGY  SCREENING  WHETHER  SUCH SCREENING IS PERFORMED BY A
 LICENSED HEALTH CARE PRACTITIONER OR BY A PROVIDER OF OBSTETRICAL AND/OR
 GYNECOLOGIC SERVICES.
   § 2. Subparagraph (B) of paragraph 14 of  subsection  (l)  of  section
 3221  of  the  insurance  law,  as amended by chapter 219 of the laws of
 2011, is amended to read as follows:
   (B) For purposes of subparagraphs  (A)  and  (C)  of  this  paragraph,
 cervical  cytology screening shall include an annual pelvic examination,
 collection and preparation of a Pap smear, and laboratory and diagnostic
 services provided in connection with examining and  evaluating  the  Pap
 smear.  AN  INSURER  SHALL  PROVIDE  THE  SAME RATE OF REIMBURSEMENT FOR
 CERVICAL CYTOLOGY SCREENING WHETHER SUCH SCREENING  IS  PERFORMED  BY  A
 LICENSED HEALTH CARE PRACTITIONER OR BY A PROVIDER OF OBSTETRICAL AND/OR
 GYNECOLOGIC SERVICES.
   §  3.  Paragraph  2 of subsection (t) of section 4303 of the insurance
 law, as amended by chapter 219 of the laws of 2011, is amended  to  read
 as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11854-02-1

 S. 8961                             2
 
   (2) For purposes of paragraph one of this subsection, cervical cytolo-
 gy  screening shall include an annual pelvic examination, collection and
 preparation of a Pap  smear,  and  laboratory  and  diagnostic  services
 provided  in  connection with examining and evaluating the Pap smear. AN
 INSURER SHALL PROVIDE THE SAME RATE OF REIMBURSEMENT FOR CERVICAL CYTOL-
 OGY  SCREENING  WHETHER SUCH SCREENING IS PERFORMED BY A LICENSED HEALTH
 CARE PRACTITIONER OR BY A PROVIDER  OF  OBSTETRICAL  AND/OR  GYNECOLOGIC
 SERVICES.
   § 4. Section 364-j is amended by adding a new subdivision 18-a to read
 as follows:
   18-A.  MANAGED CARE PROVIDERS SHALL BE REIMBURSED AT THE SAME RATE FOR
 CERVICAL CYTOLOGY SCREENING, INCLUDING BUT NOT LIMITED TO  THE  PREPARA-
 TION  OF  A  PAP SMEAR, WHETHER SUCH SCREENING IS PERFORMED BY A PRIMARY
 CARE PRACTITIONER OR BY  A  MEDICAL  SERVICES  PROVIDER  OF  OBSTETRICAL
 AND/OR GYNECOLOGIC SERVICES.
   §  5. Title 6 of article 2 of the public health law, as added by chap-
 ter 342 of the laws of 2014, is amended by adding a new section 266-a to
 read as follows:
   § 266-A. CERVICAL CYTOLOGY SCREENING. NOTWITHSTANDING ANY PROVISION OF
 LAW TO THE CONTRARY, A PRIMARY CARE PRACTITIONER  SHALL  NOT  REFUSE  TO
 PERFORM  CERVICAL  CYTOLOGY  SCREENING, INCLUDING BUT NOT LIMITED TO THE
 PREPARATION OF A PAP SMEAR, DURING A PATIENT'S REGULAR ANNUAL CHECKUP OR
 FOR NEW PATIENTS WHO HAVE NOT HAD A PAP SMEAR DONE  BY  A  PRIMARY  CARE
 PRACTITIONER OR BY A PROVIDER OF OBSTETRICAL AND/OR GYNECOLOGIC SERVICES
 WITHIN THE PRECEDING TWELVE MONTHS.
   § 6. This act shall take effect on the one hundred eightieth day after
 it  shall  have  become  a law; provided however, that the amendments to
 section 364-j of the social services law made by section  four  of  this
 act  shall  not  affect  the  repeal of such section and shall be deemed
 repealed therewith.   Effective  immediately,  the  addition,  amendment
 and/or repeal of any rule or regulation necessary for the implementation
 of  this  act  on  its  effective  date  are  authorized  to be made and
 completed on or before such effective date.

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