S T A T E O F N E W Y O R K
________________________________________________________________________
291
2015-2016 Regular Sessions
I N A S S E M B L Y
(PREFILED)
January 7, 2015
___________
Introduced by M. of A. ROZIC, AUBRY, ABINANTI, BORELLI, COOK, GRAF,
JAFFEE, LAVINE, MILLER, O'DONNELL, SCARBOROUGH, SEPULVEDA, SKOUFIS,
COLTON, CRESPO, BRONSON, WEPRIN, OTIS, LUPINACCI, ROBINSON -- Multi-
Sponsored by -- M. of A. ARROYO, BRENNAN, CERETTO, CLARK, CROUCH,
GUNTHER, KEARNS, McLAUGHLIN, PERRY, RAIA, RIVERA, ROBERTS, SCHIMEL,
SIMANOWITZ -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring health
insurance policies to fully cover comprehensive genetic testing for
breast, ovarian, prostate, colon and lung cancers in certain cases
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. This act shall be known and may be cited as the "Ana Lucia
act".
S 2. Paragraph 11 of subsection (i) of section 3216 of the insurance
law is amended by adding a new subparagraph (F) to read as follows:
(F) (I) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
HENSIVE GENETIC TESTING FOR BREAST CANCER ONLY IF RECOMMENDED BY A
BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
(II) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
S 3. Paragraph 11-a of subsection (i) of section 3216 of the insurance
law is amended by adding a new subparagraph (C) to read as follows:
(C) (I) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
HENSIVE GENETIC TESTING FOR PROSTATIC CANCER ONLY IF RECOMMENDED BY A
BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
(II) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01732-02-5
A. 291 2
S 4. Paragraph 11 of subsection (l) of section 3221 of the insurance
law is amended by adding a new subparagraph (F) to read as follows:
(F) (I) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
HENSIVE GENETIC TESTING FOR BREAST CANCER ONLY IF RECOMMENDED BY A
BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
(II) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
S 5. Paragraph 11-a of subsection (l) of section 3221 of the insurance
law is amended by adding a new subparagraph (C) to read as follows:
(C)(I) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
HENSIVE GENETIC TESTING FOR PROSTATIC CANCER ONLY IF RECOMMENDED BY A
BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
(II) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
S 6. Subsection (p) of section 4303 of the insurance law is amended by
adding a new paragraph 5 to read as follows:
(5) (I) SUCH COVERAGE SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR
COMPREHENSIVE GENETIC TESTING FOR BREAST CANCER ONLY IF RECOMMENDED BY A
BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
(II) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
S 7. Subsection (z-1) of section 4303 of the insurance law is amended
by adding a new paragraph 3 to read as follows:
(3)(A) SUCH POLICY SHALL PROVIDE ADDITIONAL FULL COVERAGE FOR COMPRE-
HENSIVE GENETIC TESTING FOR PROSTATIC CANCER ONLY IF RECOMMENDED BY A
BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
(B) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
S 8. Subsection (i) of section 3216 of the insurance law is amended by
adding three new paragraphs 11-b, 11-c and 11-d to read as follows:
(11-B) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL
OR MEDICAL CARE SHALL PROVIDE FULL COVERAGE FOR GENETIC SCREENING FOR
OVARIAN CANCER ONLY IF RECOMMENDED BY A BOARD-CERTIFIED GENETICIST OR A
BOARD-CERTIFIED GENETIC COUNSELOR.
(B) SUCH ADDITIONAL COVERAGE SHALL NOT BE SUBJECT TO ANNUAL DEDUCT-
IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
(11-C) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL
OR MEDICAL CARE SHALL PROVIDE FULL COVERAGE FOR GENETIC SCREENING FOR
COLON CANCER ONLY IF RECOMMENDED BY A BOARD-CERTIFIED GENETICIST OR A
BOARD-CERTIFIED GENETIC COUNSELOR.
(B) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
(11-D) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL
OR MEDICAL CARE SHALL PROVIDE FULL COVERAGE FOR GENETIC SCREENING FOR
LUNG CANCER ONLY IF RECOMMENDED BY A BOARD-CERTIFIED GENETICIST OR A
BOARD-CERTIFIED GENETIC COUNSELOR.
(B) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
S 9. Subsection (l) of section 3221 of the insurance law is amended by
adding three new paragraphs 11-b, 11-c and 11-d to read as follows:
A. 291 3
(11-B) (A) EVERY INSURER DELIVERING A GROUP OR BLANKET POLICY OR ISSU-
ING A GROUP OR BLANKET POLICY FOR DELIVERY IN THIS STATE THAT PROVIDES
COVERAGE FOR HOSPITAL, SURGICAL OR MEDICAL CARE SHALL PROVIDE FULL
COVERAGE OR GENETIC SCREENING FOR OVARIAN CANCER ONLY IF RECOMMENDED BY
A BOARD-CERTIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
(B) SUCH ADDITIONAL COVERAGE SHALL NOT BE SUBJECT TO ANNUAL DEDUCT-
IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
(11-C) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL
OR MEDICAL CARE SHALL PROVIDE FULL COVERAGE FOR GENETIC SCREENING FOR
COLON CANCER ONLY IF RECOMMENDED BY A BOARD-CERTIFIED GENETICIST OR A
BOARD-CERTIFIED GENETIC COUNSELOR.
(B) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
(11-D) (A) EVERY POLICY THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL
OR MEDICAL CARE SHALL PROVIDE FULL COVERAGE FOR GENETIC SCREENING FOR
LUNG CANCER ONLY IF RECOMMENDED BY A BOARD-CERTIFIED GENETICIST OR A
BOARD-CERTIFIED GENETIC COUNSELOR.
(B) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
S 10. Section 4303 of the insurance law is amended by adding three new
subsections (p-1), (p-2) and (p-3) to read as follows:
(P-1) (1) A MEDICAL EXPENSE INDEMNITY CORPORATION, A HOSPITAL SERVICE
CORPORATION OR A HEALTH SERVICE CORPORATION THAT PROVIDES COVERAGE FOR
HOSPITAL, SURGICAL OR MEDICAL CARE SHALL PROVIDE FULL COVERAGE FOR
GENETIC SCREENING FOR OVARIAN CANCER ONLY IF RECOMMENDED BY A BOARD-CER-
TIFIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
(2) SUCH ADDITIONAL COVERAGE SHALL NOT BE SUBJECT TO ANNUAL DEDUCT-
IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
(P-2) (1) A MEDICAL EXPENSE INDEMNITY CORPORATION, A HOSPITAL SERVICE
CORPORATION OR A HEALTH SERVICE CORPORATION THAT PROVIDES COVERAGE FOR
HOSPITAL, SURGICAL OR MEDICAL CARE SHALL PROVIDE FULL COVERAGE FOR
GENETIC SCREENING FOR COLON CANCER ONLY IF RECOMMENDED BY A BOARD-CERTI-
FIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
(2) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
(P-3) (1) A MEDICAL EXPENSE INDEMNITY CORPORATION, A HOSPITAL SERVICE
CORPORATION OR A HEALTH SERVICE CORPORATION THAT PROVIDES COVERAGE FOR
HOSPITAL, SURGICAL OR MEDICAL CARE SHALL PROVIDE FULL COVERAGE FOR
GENETIC SCREENING FOR LUNG CANCER ONLY IF RECOMMENDED BY A BOARD-CERTI-
FIED GENETICIST OR A BOARD-CERTIFIED GENETIC COUNSELOR.
(2) ALL COSTS ASSOCIATED WITH SUCH ADDITIONAL FULL COVERAGE SHALL NOT
BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE BUT SHALL BE BORNE
SOLELY BY THE INSURER.
S 11. This act shall take effect on the sixtieth day after it shall
have become a law.