Senate Bill S1196

Signed By Governor
2023-2024 Legislative Session

Requires health insurance policies and medicaid to cover biomarker testing for certain purposes

download bill text pdf

Sponsored By

Current Bill Status - Signed by Governor


  • 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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Votes

Bill Amendments

co-Sponsors

2023-S1196 - Details

See Assembly Version of this Bill:
A1673
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L
Versions Introduced in 2021-2022 Legislative Session:
S8147, A9149

2023-S1196 - Summary

Requires health insurance policies and medicaid to cover biomarker testing for diagnosis, treatment, appropriate management, or ongoing monitoring of a covered person's disease or condition when the test is supported by medical and scientific evidence.

2023-S1196 - Sponsor Memo

2023-S1196 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1196
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 10, 2023
                                ___________
 
 Introduced  by  Sens.  PERSAUD, BROUK, CLEARE, GOUNARDES, HOYLMAN-SIGAL,
   MANNION, MAY, MYRIE, THOMAS -- 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 and medicaid to  cover
   biomarker testing for certain purposes
 
   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  WHICH  PROVIDES MEDICAL, MAJOR MEDICAL, OR
 SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR BIOMARKER
 TESTING FOR THE PURPOSES OF DIAGNOSIS,  TREATMENT,  APPROPRIATE  MANAGE-
 MENT,  OR  ONGOING MONITORING OF A COVERED PERSON'S DISEASE OR CONDITION
 WHEN THE TEST IS SUPPORTED BY MEDICAL AND SCIENTIFIC  EVIDENCE,  INCLUD-
 ING, BUT NOT LIMITED TO:
   (I) LABELED INDICATIONS FOR A TEST APPROVED OR CLEARED BY THE FOOD AND
 DRUG  ADMINISTRATION  OF THE UNITED STATES GOVERNMENT OR INDICATED TESTS
 FOR A FOOD AND DRUG ADMINISTRATION APPROVED DRUG;
   (II) CENTERS FOR MEDICARE  AND  MEDICAID  SERVICES  NATIONAL  COVERAGE
 DETERMINATIONS  AND  MEDICARE  ADMINISTRATIVE  CONTRACTOR LOCAL COVERAGE
 DETERMINATIONS; OR
   (III) NATIONALLY RECOGNIZED CLINICAL PRACTICE GUIDELINES AND CONSENSUS
 STATEMENTS.
   (B) SUCH COVERAGE SHALL BE PROVIDED  IN  A  MANNER  THAT  SHALL  LIMIT
 DISRUPTIONS  IN CARE INCLUDING THE NEED FOR MULTIPLE BIOPSIES OR BIOSPE-
 CIMEN SAMPLES.
   (C) THE COVERED PERSON AND PRESCRIBING PRACTITIONER SHALL HAVE  ACCESS
 TO  A  CLEAR,  READILY  ACCESSIBLE, AND CONVENIENT PROCESS TO REQUEST AN
 EXCEPTION TO A COVERAGE POLICY PROVIDED PURSUANT TO  THE  PROVISIONS  OF
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02625-01-3
 S. 1196                             2
              

co-Sponsors

2023-S1196A (ACTIVE) - Details

See Assembly Version of this Bill:
A1673
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L
Versions Introduced in 2021-2022 Legislative Session:
S8147, A9149

2023-S1196A (ACTIVE) - Summary

Requires health insurance policies and medicaid to cover biomarker testing for diagnosis, treatment, appropriate management, or ongoing monitoring of a covered person's disease or condition when the test is supported by medical and scientific evidence.

2023-S1196A (ACTIVE) - Sponsor Memo

2023-S1196A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1196--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 10, 2023
                                ___________
 
 Introduced  by  Sens.  PERSAUD,  ADDABBO,  BROUK,  CHU,  CLEARE, COMRIE,
   COONEY, GALLIVAN, GIANARIS,  GONZALEZ,  GOUNARDES,  GRIFFO,  HARCKHAM,
   HELMING,  HOYLMAN-SIGAL,  KENNEDY,  KRUEGER,  MANNION,  MATTERA,  MAY,
   MYRIE, PALUMBO, PARKER, RIVERA, SALAZAR,  SCARCELLA-SPANTON,  SERRANO,
   SKOUFIS, STAVISKY, THOMAS, WEIK -- read twice and ordered printed, and
   when printed to be committed to the Committee on Insurance -- reported
   favorably  from  said  committee  and  committed  to  the Committee on
   Finance -- committee discharged, bill amended,  ordered  reprinted  as
   amended and recommitted to said committee
 
 AN  ACT  to  amend  the  insurance  law  and the social services law, in
   relation to requiring health insurance policies and medicaid to  cover
   biomarker testing for certain purposes
 
   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  WHICH  PROVIDES MEDICAL, MAJOR MEDICAL, OR
 SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR BIOMARKER
 TESTING FOR THE PURPOSES OF DIAGNOSIS,  TREATMENT,  APPROPRIATE  MANAGE-
 MENT,  OR  ONGOING MONITORING OF A COVERED PERSON'S DISEASE OR CONDITION
 WHEN THE TEST PROVIDES CLINICAL UTILITY TO THE PATIENT  AS  DEMONSTRATED
 BY MEDICAL AND SCIENTIFIC EVIDENCE, INCLUDING, BUT NOT LIMITED TO:
   (I)  LABELED INDICATIONS FOR A TEST APPROVED OR CLEARED BY THE FEDERAL
 FOOD AND DRUG ADMINISTRATION OR INDICATED TESTS  FOR  A  FOOD  AND  DRUG
 ADMINISTRATION APPROVED DRUG;
   (II)  CENTERS  FOR  MEDICARE  AND  MEDICAID SERVICES NATIONAL COVERAGE
 DETERMINATIONS AND MEDICARE  ADMINISTRATIVE  CONTRACTOR  LOCAL  COVERAGE
 DETERMINATIONS; OR
   (III)  NATIONALLY RECOGNIZED CLINICAL PRACTICE GUIDELINES SUCH AS, BUT
 NOT LIMITED TO, THOSE OF THE NATIONAL COMPREHENSIVE  CANCER  NETWORK  OR
 THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02625-06-3
              

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