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