NY State Senate Bill 2009-S4516

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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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 06, 2010	referred to insurance
Apr 24, 2009	referred to insurance

co-Sponsors

2009-S4516 (ACTIVE) - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L

2009-S4516 (ACTIVE) - Summary

Requires coverage of orally administered chemotherapy treatments.

2009-S4516 (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S4516

 TITLE OF BILL :  An act to amend the insurance law, in relation to
policy coverage of chemotherapy treatment

 PURPOSE OF BILL :  This bill would require health insurance plans in
New York to cover orally administered chemotherapy treatment no less
favorably than intravenously administered or injected chemotherapy
treatments.

 SUMMARY OF PROVISIONS :  This bill amends section 3221 subdivision k
of the Insurance law by adding a new subsection 9-A.

 JUSTIFICATION :  Medical advances over the years have led to many
beneficial medical treatments. One of these medical advances has been
the development of an oral chemotherapy treatment. With this
treatment, a patient is able to undergo chemotherapy by taking a pill
in the comfort of their own home. This means that the patient does not
have to go to the hospital for the traditional intravenous or
injectable form of chemotherapy that is most commonly thought of when
chemotherapy is discussed. In addition to being able to do the
treatment in their own home, the patient also receives the added
benefit of possibly not having the traditionally chemotherapy side
effects such as hair loss and the patient also sleeps through the
treatment as the pill is administered at bedtime, meaning that the
patient sleeps while the drugs do their work. This medical advance is

significant. However, due to a classification by insurance companies,
many patients cannot reap the benefits of this advance. As this
chemotherapy treatment comes in the form of a pill, insurance
companies are classifying this treatment as a prescription drug
treatment. This means that the patient does not get the treatment
covered as a traditional chemotherapy treatment and must pay for the
drug as though it were an average prescription drug. As this is not an
average prescription drug, the co-pay and coverage for this drug are
limited. Most patients must payout of pocket in the highest drug price
category. This means that for the majority of patients, the pill form
of chemotherapy will cost tens of thousands of dollars.  This is
obviously cost prohibitive and limits patient access to a viable and
desirable alternative to traditional chemotherapy treatment.
Traditional chemotherapy treatment is usually covered under the major
medical benefits, and once the deductible is met, if there even is
one, the treatment is 100% covered. This amendment to the New York
State Insurance Law would correct this discrepancy and ensure that
chemotherapy treatment, no matter how administered, is covered equally
by insurance companies.

 LEGISLATIVE HISTORY : None.

 FISCAL IMPLICATIONS : None to the state.

 EFFECTIVE DATE :  This law would take effect immediately.

2009-S4516 (ACTIVE) - Bill Text download pdf

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

                                  4516

                       2009-2010 Regular Sessions

                            I N  S E N A T E

                             April 24, 2009
                               ___________

Introduced  by  Sen.  LANZA  -- 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  policy  coverage  of
  chemotherapy treatment

  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 12-a to read as follows:
  (12-A)  EVERY  POLICY  DELIVERED  OR ISSUED FOR DELIVERY IN THIS STATE
THAT PROVIDES MEDICAL,  MAJOR  MEDICAL,  OR  SIMILAR  COMPREHENSIVE-TYPE
COVERAGE  AND  PROVIDES COVERAGE FOR CANCER CHEMOTHERAPY TREATMENT SHALL
PROVIDE COVERAGE FOR A PRESCRIBED, ORALLY ADMINISTERED ANTICANCER  MEDI-
CATION  USED TO KILL OR SLOW THE GROWTH OF CANCEROUS CELLS ON A BASIS NO
LESS FAVORABLE THAN INTRAVENOUSLY ADMINISTERED OR INJECTED CANCER  MEDI-
CATIONS.
  S 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 9-a to read as follows:
  (9-A)  EVERY  GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY
IN THIS STATE THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR  SIMILAR  COMPRE-
HENSIVE-TYPE  COVERAGE  AND  PROVIDES  COVERAGE  FOR CANCER CHEMOTHERAPY
TREATMENT SHALL PROVIDE COVERAGE FOR A PRESCRIBED,  ORALLY  ADMINISTERED
ANTICANCER MEDICATION USED TO KILL OR SLOW THE GROWTH OF CANCEROUS CELLS
ON A BASIS NO LESS FAVORABLE THAN INTRAVENOUSLY ADMINISTERED OR INJECTED
CANCER MEDICATIONS.
  S  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (q-1) to read as follows:
  (Q-1) EVERY POLICY ISSUED BY A MEDICAL EXPENSE INDEMNITY  CORPORATION,
A  HOSPITAL  SERVICE  CORPORATION  OR  A  HEALTH SERVICE CORPORATION FOR
DELIVERY IN THIS STATE THAT PROVIDES MEDICAL, MAJOR MEDICAL, OR  SIMILAR
COMPREHENSIVE-TYPE COVERAGE AND PROVIDES COVERAGE FOR CANCER CHEMOTHERA-
PY  TREATMENT  SHALL  PROVIDE COVERAGE FOR A PRESCRIBED, ORALLY ADMINIS-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10074-02-9

S. 4516                             2

TERED ANTICANCER MEDICATION USED TO KILL OR SLOW THE GROWTH OF CANCEROUS
CELLS ON A BASIS NO LESS FAVORABLE THAN  INTRAVENOUSLY  ADMINISTERED  OR
INJECTED CANCER MEDICATIONS.
  S  4.  This act shall take effect immediately and shall apply to poli-
cies issued, modified, or renewed on or after such effective date.

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Senate Bill S4516

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Archive: Last Bill Status - In Senate Committee Insurance Committee

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co-Sponsors

2009-S4516 (ACTIVE) - Details

2009-S4516 (ACTIVE) - Summary

2009-S4516 (ACTIVE) - Sponsor Memo

2009-S4516 (ACTIVE) - Bill Text download pdf

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Sponsored By

Andrew J. Lanza

Archive: Last Bill Status - In Senate Committee Insurance Committee

Actions

co-Sponsors

Liz Krueger

2009-S4516 (ACTIVE) - Details

2009-S4516 (ACTIVE) - Summary

2009-S4516 (ACTIVE) - Sponsor Memo

2009-S4516 (ACTIVE) - Bill Text download pdf

Comments