Senate Bill S841A

2011-2012 Legislative Session

Removes cancer screening deductibles, copayments and coinsurance

download bill text pdf

Archive: Last Bill Status - In Senate Committee Rules 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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Actions

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Mar 12, 2012	committee discharged and committed to rules notice of committee consideration - requested
Jan 26, 2012	print number 841a
Jan 26, 2012	amend and recommit to insurance
Jan 04, 2012	referred to insurance
Jan 05, 2011	referred to insurance

Bill Amendments

co-Sponsors

2011-S841 - Details

Current Committee:: Senate Rules
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221, 4303, 4321 & 4322, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S7064
2013-2014: S639

2011-S841 - Summary

Removes cancer screening deductibles, copayments and coinsurance.

2011-S841 - Sponsor Memo

                                BILL NUMBER:S841

TITLE OF BILL:
An act
to amend the insurance law, in relation to cancer screening deductibles
and copayments

PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this legislation is to eliminate copayments for certain
cancer screenings in order to encourage preventive care.

SUMMARY OF SPECIFIC PROVISIONS:
The bill would amend:
Section 1. Subparagraph (B) of paragraph 11 and subparagraph (C) of
paragraph 15 of subsection (i) of section 3216 of the insurance law,
subparagraph (B) as added by chapter 417 of the laws of 1989 and
subparagraph (C) as amended by chapter 43 of the laws of 1993 to
state that such coverage shall not be subject to annual deductibles
and coinsurance, as may be deemed appropriate by the superintendent
and as is consistent with those established for other benefits within
a given policy.

Section 2. Subparagraph (B)of paragraph 11 and subparagraph (C) of
paragraph 14 of subsection (1) of section 3221 of the insurance law,
as amended by chapter 554 of the laws of 2002 are amended to state
that such coverage shall not be subject to annual deductibles and

coinsurance, as may be deemed appropriate by the superintendent and
as is consistent with those established for other benefits within a
given policy.

Section 3. The closing paragraph of paragraph 1 of subsection (p) of
paragraph 1 of subsection (t) of section 4303 of the insurance law,
as amended by chapter 554 of the laws of 2002 are amended.

Section 4. Subsection (c) of section 4321 of the insurance law, as
added by chapter 504 of the laws of 1995 is amended to exempt
mammography screening and cervical cytology screening from a fifteen
dollar HMO co-pay.

Section 5. Subsections (c) and (d) of section 4322 of the insurance
law, as added by chapter 504 of the laws of 1995, are amended for the
in-plan benefit system to exempt mammography screening and cervical
cytology screening from a ten dollar copayment. The out-of-plan
benefit system also shall exempt these cancer screenings from
deductible or co-insurance costs.

JUSTIFICATION:
It is well established that our country and state must transition to a
more prevention.-based health care system. In addition to being
considerably more cost effective than our current treatment regime,
preventive care will save lives and improve health outcomes by
encouraging the early detection and treatment of illness.

This legislation would accomplish one objective within this broader
effort by eliminating required insurance co-payments for most
varieties of cancer screenings, with the exception of tests whose


radiation levels require a more restrictive testing regimen. Although
modest in price compared to costs borne by the uninsured, these
copayments act as a disincentive and their
elimination would increase the number of people who receive cancer
testing. A New England Journal of Medicine study found that a $10
copayment reduced the percentage of women screened for breast cancer
from 78% to 69% compared to an equivalent group eligible for free
testing.

PRIOR LEGISLATIVE HISTORY:
Previously introduced.

FISCAL IMPLICATIONS:
None to the state.

EFFECTIVE DATE:
This act shall take effect immediately and the
provisions of this act shall apply to policies and contracts issued,
renewed, modified or altered on or after such effective date.

2011-S841 - Bill Text download pdf

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

                                   841

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 5, 2011
                               ___________

Introduced  by Sen. STAVISKY -- 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  cancer  screening
  deductibles and copayments

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subparagraph (B) of paragraph 11 and  subparagraph  (C)  of
paragraph  15  of  subsection  (i) of section 3216 of the insurance law,
subparagraph (B) of paragraph 11 as added by chapter 417 of the laws  of
1989  and  subparagraph  (C) of paragraph 15 as amended by chapter 43 of
the laws of 1993, are amended to read as follows:
  (B) Such coverage [may] SHALL NOT be subject to annual deductibles and
coinsurance [as may be deemed appropriate by the superintendent  and  as
are  consistent with those established for other benefits within a given
policy].
  (C) Such coverage [may] SHALL NOT be subject to annual deductibles and
coinsurance [as may be deemed appropriate by the superintendent  and  as
are  consistent with those established for other benefits within a given
policy].
  S 2.  Subparagraph (B) of paragraph 11 and subparagraph (C)  of  para-
graph  14  of  subsection  (1)  of section 3221 of the insurance law, as
amended by chapter 554 of the laws of  2002,  are  amended  to  read  as
follows:
  (B) Such coverage [may] SHALL NOT be subject to annual deductibles and
coinsurance  [as  may be deemed appropriate by the superintendent and as
are consistent with those established for other benefits within a  given
policy].
  (C) Such coverage [may] SHALL NOT be subject to annual deductibles and
coinsurance  [as  may be deemed appropriate by the superintendent and as

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01826-02-1

S. 841                              2

are consistent with those established for other benefits within a  given
policy].
  S  3. The closing paragraph of paragraph 1 of subsection (p) and para-
graph 1 of subsection (t) of section  4303  of  the  insurance  law,  as
amended  by  chapter  554  of  the  laws of 2002, are amended to read as
follows:
  The coverage required in this paragraph [may] SHALL NOT  be subject to
annual deductibles and coinsurance [as may be deemed appropriate by  the
superintendent  and  as  are consistent with those established for other
benefits within a given policy].
  (1) A medical expense indemnity corporation, a hospital service corpo-
ration or a health  service  corporation  which  provides  coverage  for
hospital, surgical, or medical care shall provide coverage for an annual
cervical cytology screening for cervical cancer and its precursor states
for  women  aged  eighteen and older.   Such coverage [may] SHALL NOT be
subject to annual deductibles and coinsurance [as may be  deemed  appro-
priate  by  the  superintendent  and as are consistent with those estab-
lished for other benefits within a given contract].
  S 4. Subsection (c) of section 4321 of the insurance law, as added  by
chapter 504 of the laws of 1995, is amended to read as follows:
  (c)  The health maintenance organization shall impose a fifteen dollar
copayment on all visits to a physician or other provider with the excep-
tion of visits for pre-natal and post-natal care or  well  child  visits
provided  pursuant  to  paragraph  two  of  subsection  (j), MAMMOGRAPHY
SCREENING PROVIDED PURSUANT TO SUBSECTION  (P),  AND  CERVICAL  CYTOLOGY
SCREENING  PROVIDED  PURSUANT TO SUBSECTION (T) of section four thousand
three hundred three of this article for which no copayment shall  apply.
A  copayment  of fifteen dollars shall be imposed on equipment, supplies
and self-management education for the treatment  of  diabetes.  A  fifty
dollar  copayment shall be imposed on emergency services rendered in the
emergency room of a hospital; however, this copayment must be waived  if
hospital  admission  results.  Surgical  services  shall be subject to a
copayment of the lesser of twenty percent of the cost of  such  services
or  two  hundred dollars per occurrence. A five hundred dollar copayment
shall be imposed on inpatient hospital services per continuous  hospital
confinement. Ambulatory surgical services shall be subject to a facility
copayment  charge  of  seventy-five  dollars. Coinsurance of ten percent
shall apply to visits for the diagnosis and treatment of mental, nervous
or emotional disorders or ailments.
  S 5. Subsections (c) and (d) of section 4322 of the insurance law,  as
added  by  chapter  504  of  the  laws  of  1995, are amended to read as
follows:
  (c) The in-plan benefit system shall impose a ten dollar copayment  on
all visits to a physician or other provider with the exception of visits
for pre-natal and post-natal care or well child visits provided pursuant
to  paragraph  two  of  subsection  (j),  MAMMOGRAPHY SCREENING PROVIDED
PURSUANT TO SUBSECTION (P), AND  CERVICAL  CYTOLOGY  SCREENING  PROVIDED
PURSUANT  TO SUBSECTION (T) of section four thousand three hundred three
of this article for which no copayment shall apply. A copayment  of  ten
dollars  shall  be  imposed  on  equipment, supplies and self-management
education for the treatment of  diabetes.  Coinsurance  of  ten  percent
shall apply to visits for the diagnosis and treatment of mental, nervous
or emotional disorders or ailments. A thirty-five dollar copayment shall
be  imposed  on  emergency  services rendered in the emergency room of a
hospital; however, this copayment must be waived if  hospital  admission
results.

S. 841                              3

  (d)  The  out-of-plan  benefit  system shall have an annual deductible
established at one thousand dollars per calendar year for an  individual
and  two  thousand  dollars  per year for a family. Coinsurance shall be
established at twenty percent with the health  maintenance  organization
or  insurer paying eighty percent of the usual, customary and reasonable
charges, or eighty percent of the amounts listed on a fee schedule filed
with and approved by the  superintendent  which  provides  a  comparable
level of reimbursement. Coinsurance of ten percent shall apply to outpa-
tient  visits  for  the  diagnosis  and  treatment of mental, nervous or
emotional disorders or ailments. The benefits described in  subparagraph
(F)  of paragraph three, SUBPARAGRAPHS (D) AND (E) OF PARAGRAPH FOUR and
paragraphs seventeen and eighteen of  subsection  (b)  of  this  section
shall  not  be  subject  to  the deductible or coinsurance. The benefits
described in paragraph nine of subsection (b) of this section shall  not
be  subject  to  the  deductible.  The out-of-plan out-of-pocket maximum
deductible and  coinsurance  shall  be  established  at  three  thousand
dollars  per  calendar  year for an individual and five thousand dollars
per calendar year for a family. The out-of-plan lifetime benefit maximum
shall be established at five hundred thousand dollars.
  S 6. This act shall take effect immediately and the provisions of this
act shall apply to policies and  contracts  issued,  renewed,  modified,
altered or amended on or after such effective date.

co-Sponsors

2011-S841A (ACTIVE) - Details

Current Committee:: Senate Rules
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221, 4303, 4321 & 4322, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S7064
2013-2014: S639

2011-S841A (ACTIVE) - Summary

Removes cancer screening deductibles, copayments and coinsurance.

2011-S841A (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S841A

TITLE OF BILL:
An act
to amend the insurance law, in relation to cancer screening deductibles
and copayments

PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this legislation is to eliminate copayments for certain
cancer screenings in order, to encourage preventive care.

SUMMARY OF SPECIFIC PROVISIONS:
The following sections of law are
amended provide that mammography screening and cervical cytology
screening provided under the insurance law shall not be subject to
annual deductibles and coinsurance costs.

Section 1. Subparagraph (B) of paragraph 11 and subparagraph (C) of
paragraph 15 of subsection (i) of section 3216 of the insurance law,
as amended by chapter 219 of the laws of 2011 are amended.

Section 2. Subparagraph (B)of paragraph 11 and subparagraph (C) of
paragraph 14 of subsection (1) of section 3221 of the insurance law,
as amended by chapter 219 of the laws of 2011, are amended.

Section 3: Subparagraph (D) of paragraph 1 of subsection (p) and

paragraph 1 of subsection (t) of section 4303 of the insurance law,
as amended by chapter 219 of the laws of 2011, are amended.

Section 4. Subsection (c) of section 4321 of the insurance law, as
amended by chapter 219 of the laws of 2011, are amended.

Section 5. Subsections (c) and (d) of section 4322 of the insurance
law, as amended by chapter 219 of the laws of 2011, are amended.

JUSTIFICATION:
It is well established that our country and state must transition to a
more prevention-based health care system. In addition to being
considerably more cost effective than our current treatment regime,
preventive care will save lives and improve health outcomes by
encouraging the early detection and treatment of illness.

This legislation would accomplish one objective within this broader
effort by eliminating required insurance co-payments for most
varieties of cancer screenings, with the exception of tests whose
radiation levels require a more restrictive testing regimen. Although
modest in price compared to costs borne by the uninsured, these
copayments act as a disincentive and their elimination would increase
the number of people who receive cancer testing. A New England
Journal of Medicine study found that a $10 copayment reduced the
percentage of women screened for breast cancer from 78% to 69%
compared to an equivalent group eligible for free testing.

PRIOR LEGISLATIVE HISTORY:
Previously introduced.


FISCAL IMPLICATIONS:
None to the state.

EFFECTIVE DATE:
This act shall take effect immediately and the
provisions of this act shall apply to policies and contracts issued,
renewed, modified or altered on or after such effective date.

2011-S841A (ACTIVE) - Bill Text download pdf

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

                                 841--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 5, 2011
                               ___________

Introduced  by  Sens.  STAVISKY,  OPPENHEIMER  -- read twice and ordered
  printed, and when printed to be committed to the Committee  on  Insur-
  ance  --  recommitted to the Committee on Insurance in accordance with
  Senate Rule 6, sec. 8 -- committee discharged, bill  amended,  ordered
  reprinted as amended and recommitted to said committee

AN  ACT  to  amend  the  insurance  law, in relation to cancer screening
  deductibles and copayments

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  Subparagraph  (B) of paragraph 11 and subparagraph (C) of
paragraph 15 of subsection (i) of section 3216 of the insurance law,  as
amended  by  chapter  219  of  the  laws of 2011, are amended to read as
follows:
  (B) Such coverage required pursuant to subparagraph (A) or (C) of this
paragraph [may] SHALL NOT be subject to annual deductibles  and  coinsu-
rance  [as  may  be  deemed appropriate by the superintendent and as are
consistent with those established for  other  benefits  within  a  given
policy].
  (C) Such coverage required pursuant to subparagraph (A) or (B) of this
paragraph  [may]  SHALL NOT be subject to annual deductibles and coinsu-
rance [as may be deemed appropriate by the  superintendent  and  as  are
consistent  with  those  established  for  other benefits within a given
policy].
  S 2.  Subparagraph (B) of paragraph 11 and subparagraph (C)  of  para-
graph  14  of  subsection  (1)  of section 3221 of the insurance law, as
amended by chapter 219 of the laws of  2011,  are  amended  to  read  as
follows:
  (B) Such coverage required pursuant to subparagraph (A) or (C) of this
paragraph  [may]  SHALL NOT be subject to annual deductibles and coinsu-
rance [as may be deemed appropriate by the  superintendent  and  as  are

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

                                                           LBD01826-05-1

S. 841--A                           2

consistent  with  those  established  for  other benefits within a given
policy].
  (C) Such coverage required pursuant to subparagraph (A) or (B) of this
paragraph  [may]  SHALL NOT be subject to annual deductibles and coinsu-
rance [as may be deemed appropriate by the  superintendent  and  as  are
consistent  with  those  established  for  other benefits within a given
policy].
  S 3. Subparagraph (D) of paragraph 1 of subsection (p) and paragraph 1
of subsection (t) of section 4303 of the insurance law,  as  amended  by
chapter 219 of the laws of 2011, are amended to read as follows:
  (D)  The  coverage required in this paragraph or paragraph two of this
subsection [may] SHALL NOT be subject to annual deductibles and  coinsu-
rance  [as  may  be  deemed appropriate by the superintendent and as are
consistent with those established for  other  benefits  within  a  given
contract].
  (1) A medical expense indemnity corporation, a hospital service corpo-
ration or a health service corporation that provides coverage for hospi-
tal,  surgical,  or  medical  care  shall provide coverage for an annual
cervical cytology screening for cervical cancer and its precursor states
for women aged eighteen and older. Such coverage required by this  para-
graph  [may]  SHALL NOT be subject to annual deductibles and coinsurance
[as may be deemed appropriate by the superintendent and as are  consist-
ent with those established for other benefits within a given contract].
  S  4.  Subsection (c) of section 4321 of the insurance law, as amended
by chapter 219 of the laws of 2011, is amended to read as follows:
  (c) The health maintenance organization shall impose a fifteen  dollar
copayment on all visits to a physician or other provider with the excep-
tion  of  visits  for  pre-natal  and post-natal care, well child visits
provided pursuant  to  paragraph  two  of  subsection  (j),  MAMMOGRAPHY
SCREENING  PROVIDED  PURSUANT  TO  SUBSECTION (P), AND CERVICAL CYTOLOGY
SCREENING PROVIDED PURSUANT TO SUBSECTION (T) of section  four  thousand
three hundred three of this article, preventive health services provided
pursuant  to  subparagraph  (F)  of  paragraph four of subsection (b) of
section four thousand three hundred twenty-two of this article, or items
or services for bone mineral density provided pursuant  to  subparagraph
(D)  of  paragraph twenty-six of subsection (b) of section four thousand
three hundred twenty-two of this article for which  no  copayment  shall
apply.  A  copayment  of  fifteen dollars shall be imposed on equipment,
supplies and self-management education for the treatment of diabetes.  A
fifty  dollar  copayment shall be imposed on emergency services rendered
in the emergency room of a hospital; however,  this  copayment  must  be
waived if hospital admission results. Surgical services shall be subject
to  a  copayment  of  the  lesser  of twenty percent of the cost of such
services or two hundred dollars per occurrence. A  five  hundred  dollar
copayment shall be imposed on inpatient hospital services per continuous
hospital confinement. Ambulatory surgical services shall be subject to a
facility  copayment  charge  of seventy-five dollars. Coinsurance of ten
percent shall apply to visits for the diagnosis and treatment of mental,
nervous or emotional disorders or ailments.
  S 5. Subsections (c) and (d) of section 4322 of the insurance law,  as
amended  by  chapter  219  of  the  laws of 2011, are amended to read as
follows:
  (c) The in-plan benefit system shall impose a ten dollar copayment  on
all visits to a physician or other provider with the exception of visits
for  pre-natal  and post-natal care, well child visits provided pursuant
to paragraph two  of  subsection  (j),  MAMMOGRAPHY  SCREENING  PROVIDED

S. 841--A                           3

PURSUANT  TO  SUBSECTION  (P),  AND CERVICAL CYTOLOGY SCREENING PROVIDED
PURSUANT TO SUBSECTION (T) of section four thousand three hundred  three
of this article, preventive health services provided pursuant to subpar-
agraph  (F) of paragraph four of subsection (b) of this section or items
or services for bone mineral density provided pursuant  to  subparagraph
(D)  of paragraph twenty-six of subsection (b) of this section for which
no copayment shall apply. A copayment of ten dollars shall be imposed on
equipment, supplies and self-management education for the  treatment  of
diabetes. Coinsurance of ten percent shall apply to visits for the diag-
nosis  and  treatment  of  mental,  nervous  or  emotional  disorders or
ailments. A thirty-five dollar copayment shall be imposed  on  emergency
services  rendered  in  the  emergency room of a hospital; however, this
copayment must be waived if hospital admission results.
  (d) The out-of-plan benefit system shall  have  an  annual  deductible
established  at one thousand dollars per calendar year for an individual
and two thousand dollars per year for a  family.  Coinsurance  shall  be
established  at  twenty percent with the health maintenance organization
or insurer paying eighty percent of the usual, customary and  reasonable
charges, or eighty percent of the amounts listed on a fee schedule filed
with  and  approved  by  the  superintendent which provides a comparable
level of reimbursement. Coinsurance of ten percent shall apply to outpa-
tient visits for the diagnosis  and  treatment  of  mental,  nervous  or
emotional  disorders or ailments. The benefits described in subparagraph
(F) of paragraph three, SUBPARAGRAPHS (D) AND (E) OF PARAGRAPH FOUR  and
paragraphs  seventeen  and  eighteen  of  subsection (b) of this section
shall not be subject to the  deductible  or  coinsurance.  The  benefits
described  in paragraph nine of subsection (b) of this section shall not
be subject to the  deductible.  The  out-of-plan  out-of-pocket  maximum
deductible  and  coinsurance  shall  be  established  at  three thousand
dollars per calendar year for an individual and  five  thousand  dollars
per calendar year for a family. The out-of-plan lifetime benefit maximum
shall  be established at five hundred thousand dollars for benefits that
are not essential health benefits. A lifetime limit on the dollar amount
of essential health benefits for any  individual  shall  not  be  estab-
lished.  For  purposes  of  this subsection, "essential health benefits"
shall have the meaning ascribed by section  1302(b)  of  the  Affordable
Care Act, 42 U.S.C. S 18022(b).
  S 6. This act shall take effect immediately and the provisions of this
act  shall  apply  to  policies and contracts issued, renewed, modified,
altered or amended on or after such effective date.

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Senate Bill S841A

Sponsored By

Archive: Last Bill Status - In Senate Committee Rules Committee

Actions

Bill Amendments

co-Sponsors

2011-S841 - Details

2011-S841 - Summary

2011-S841 - Sponsor Memo

2011-S841 - Bill Text download pdf

co-Sponsors

2011-S841A (ACTIVE) - Details

2011-S841A (ACTIVE) - Summary

2011-S841A (ACTIVE) - Sponsor Memo

2011-S841A (ACTIVE) - Bill Text download pdf

Comments

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Senate Bill S841A

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Sponsored By

Toby Ann Stavisky

Archive: Last Bill Status - In Senate Committee Rules Committee

Actions

Bill Amendments

co-Sponsors

Suzi Oppenheimer

2011-S841 - Details

2011-S841 - Summary

2011-S841 - Sponsor Memo

2011-S841 - Bill Text download pdf

co-Sponsors

Tony Avella

Suzi Oppenheimer

2011-S841A (ACTIVE) - Details

2011-S841A (ACTIVE) - Summary

2011-S841A (ACTIVE) - Sponsor Memo

2011-S841A (ACTIVE) - Bill Text download pdf

Comments