S T A T E   O F   N E W   Y O R K
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                                 102--A

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                               (PREFILED)

                             January 7, 2015
                               ___________

Introduced  by  M. of A. DINOWITZ, GALEF, CUSICK, CYMBROWITZ, ZEBROWSKI,
  ORTIZ, ENGLEBRIGHT, ROZIC -- Multi-Sponsored by -- M. of  A.  BRENNAN,
  CAHILL, COLTON, COOK, GLICK, GOTTFRIED, RAIA -- read once and referred
  to  the  Committee  on  Insurance  --  recommitted to the Committee on
  Insurance in accordance with Assembly Rule  3,  sec.  2  --  committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN  ACT  to  amend the insurance law, in relation to providing insurance
  coverage for colorectal cancer early detection

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

  Section  1.  Paragraph  27  of  subsection  (i) of section 3216 of the
insurance law, as added by chapter 457 of the laws of  2010,  is  renum-
bered  paragraph  33,  paragraph 28 of subsection (i) of section 3216 of
the insurance law, as amended by chapter 11 of  the  laws  of  2012,  is
renumbered  paragraph  34  and  a  new  paragraph 35 is added to read as
follows:
  (35) (A) EVERY POLICY WHICH PROVIDES COVERAGE PURSUANT TO THIS SECTION
SHALL PROVIDE COVERAGE TO ANY NAMED SUBSCRIBER OR OTHER  PERSON  COVERED
THEREUNDER  FOR  EXPENSES INCURRED IN CONDUCTING COLORECTAL CANCER EXAM-
INATIONS AND LABORATORY TESTS AT REGULAR INTERVALS,  INCLUDING  EXPENSES
INCURRED  IN  CONDUCTING  PHYSICIAN  CONSULTATIONS FOR COLORECTAL CANCER
PRIOR TO SUCH EXAMINATIONS AND TESTS, FOR PERSONS FIFTY YEARS OF AGE  OR
OLDER  AND  FOR PERSONS OF ANY AGE WHO ARE CONSIDERED TO BE AT HIGH RISK
FOR COLORECTAL CANCER. THE METHODS OF SCREENING FOR WHICH BENEFITS SHALL
BE PROVIDED SHALL INCLUDE BUT NOT BE LIMITED TO:
  (I) A SCREENING FECAL OCCULT BLOOD TEST;
  (II) FLEXIBLE SIGMOIDOSCOPY;
  (III) COLONOSCOPY;
  (IV) BARIUM ENEMA; OR

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

                                                           LBD01543-03-6

A. 102--A                           2

  (V) THE MOST RELIABLE, MEDICALLY RECOGNIZED SCREENING TEST  AVAILABLE;
AND
  (VI) ANY COMBINATION THEREOF.
  THE  METHOD  AND  FREQUENCY  OF  SCREENING  TO BE UTILIZED SHALL BE IN
ACCORD WITH THE MOST  RECENTLY  PUBLISHED  GUIDELINES  OF  THE  AMERICAN
COLLEGE  OF GASTROENTEROLOGY OR THE AMERICAN GASTROENTEROLOGICAL ASSOCI-
ATION IN CONSULTATION WITH THE AMERICAN CANCER SOCIETY.
  (B) AS USED IN THIS PARAGRAPH, "HIGH RISK FOR COLORECTAL CANCER" SHALL
MEAN A PERSON HAS,
  (I) A FAMILY HISTORY OF  FAMILIAL  ADENOMATOUS  POLYPOSIS;  HEREDITARY
NON-POLYPOSIS  COLON  CANCER;  OR  BREAST, OVARIAN, ENDOMETRIAL OR COLON
CANCER OR POLYPS;
  (II) CHRONIC INFLAMMATORY BOWEL DISEASE; OR
  (III) A BACKGROUND, ETHNICITY OR LIFESTYLE THAT THE PHYSICIAN BELIEVES
PUTS THE PERSON AT ELEVATED RISK FOR COLORECTAL CANCER.
  S 2. Subsection (k) of section 3221 of the insurance law is amended by
adding a new paragraph 21 to read as follows:
  (21) (A) EVERY POLICY WHICH PROVIDES COVERAGE PURSUANT TO THIS SECTION
SHALL PROVIDE COVERAGE TO ANY NAMED SUBSCRIBER OR OTHER  PERSON  COVERED
THEREUNDER  FOR  EXPENSES INCURRED IN CONDUCTING COLORECTAL CANCER EXAM-
INATIONS AND LABORATORY TESTS AT REGULAR INTERVALS,  INCLUDING  EXPENSES
INCURRED  IN  CONDUCTING  PHYSICIAN  CONSULTATIONS FOR COLORECTAL CANCER
PRIOR TO SUCH EXAMINATIONS AND TESTS, FOR PERSONS FIFTY YEARS OF AGE  OR
OLDER  AND  FOR PERSONS OF ANY AGE WHO ARE CONSIDERED TO BE AT HIGH RISK
FOR COLORECTAL CANCER. THE METHODS OF SCREENING FOR WHICH BENEFITS SHALL
BE PROVIDED SHALL INCLUDE BUT NOT BE LIMITED TO:
  (I) A SCREENING FECAL OCCULT BLOOD TEST;
  (II) FLEXIBLE SIGMOIDOSCOPY;
  (III) COLONOSCOPY;
  (IV) BARIUM ENEMA; OR
  (V) THE MOST RELIABLE, MEDICALLY RECOGNIZED SCREENING TEST  AVAILABLE;
AND
  (VI) ANY COMBINATION THEREOF.
  THE  METHOD  AND  FREQUENCY  OF  SCREENING  TO BE UTILIZED SHALL BE IN
ACCORD WITH THE MOST  RECENTLY  PUBLISHED  GUIDELINES  OF  THE  AMERICAN
COLLEGE  OF GASTROENTEROLOGY OR THE AMERICAN GASTROENTEROLOGICAL ASSOCI-
ATION IN CONSULTATION WITH THE AMERICAN CANCER SOCIETY.
  (B) AS USED IN THIS PARAGRAPH, "HIGH RISK FOR COLORECTAL CANCER" SHALL
MEAN A PERSON HAS,
  (I) A FAMILY HISTORY OF  FAMILIAL  ADENOMATOUS  POLYPOSIS;  HEREDITARY
NON-POLYPOSIS  COLON  CANCER;  OR  BREAST, OVARIAN, ENDOMETRIAL OR COLON
CANCER OR POLYPS;
  (II) CHRONIC INFLAMMATORY BOWEL DISEASE; OR
  (III) A BACKGROUND, ETHNICITY OR LIFESTYLE THAT THE PHYSICIAN BELIEVES
PUTS THE PERSON AT ELEVATED RISK FOR COLORECTAL CANCER.
  S 3. Subsection (a) of section 4303 of the insurance law is amended by
adding a new paragraph 4 to read as follows:
  (4) TO PERSONS FIFTY YEARS OF AGE OR OLDER FOR SERVICES RELATED TO THE
CONDUCTING OF COLORECTAL CANCER EXAMINATIONS  AND  LABORATORY  TESTS  AT
REGULAR  INTERVALS,  INCLUDING EXPENSES INCURRED IN CONDUCTING PHYSICIAN
CONSULTATIONS FOR COLORECTAL  CANCER  PRIOR  TO  SUCH  EXAMINATIONS  AND
TESTS, INCLUDING BUT NOT LIMITED TO, COLONOSCOPIES, COLOSCOPIES, SCREEN-
ING FECAL OCCULT BLOOD TESTS, FLEXIBLE SIGMOIDOSCOPIES OR BARIUM ENEMAS.
  S  4. The superintendent of financial services shall require an insur-
er, health carrier or health benefit plan to notify  enrollees  annually
of  colorectal cancer screenings covered by such enrollees' health bene-

A. 102--A                           3

fit plan and the most recently  published  guidelines  of  the  American
College  of Gastroenterology or the American Gastroenterological Associ-
ation in consultation with the American Cancer  Society  for  colorectal
cancer  screenings  or notify enrollees at intervals consistent with the
most recently published guidelines of the American College of  Gastroen-
terology or the American Gastroenterological Association in consultation
with  the  American Cancer Society of colorectal cancer screenings which
are covered by such enrollees' health benefit plans.   The notice  shall
be  delivered by mail unless the enrollee and health carrier have agreed
on another method  of  notification.  The  superintendent  of  financial
services is authorized to promulgate necessary rules and regulations for
the purposes of providing such notification.
  S  5.  This  act  shall take effect immediately and shall apply to any
policy issued, delivered, renewed,  and/or  modified  on  or  after  the
effective date of this act.