S T A T E O F N E W Y O R K
________________________________________________________________________
318
2015-2016 Regular Sessions
I N A S S E M B L Y
(PREFILED)
January 7, 2015
___________
Introduced by M. of A. PRETLOW -- read once and referred to the Commit-
tee on Insurance
AN ACT to amend the insurance law, in relation to requiring coverage for
genetic testing in accident and health insurance policies
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Section 3216 of the insurance law is amended by adding a
new subsection (n) to read as follows:
(N) (1) (A) FOR PURPOSES OF THIS SUBSECTION: "PREDISPOSING GENETIC
CHARACTERISTIC" SHALL MEAN ANY INHERITED GENE OR CHROMOSOME, OR ALTER-
ATION THEREOF, AND DETERMINED BY A GENETIC TEST OR INFERRED FROM INFOR-
MATION DERIVED FROM AN INDIVIDUAL OR FAMILY MEMBER THAT IS SCIENTIF-
ICALLY OR MEDICALLY BELIEVED TO PREDISPOSE AN INDIVIDUAL OR THE
OFFSPRING OF THAT INDIVIDUAL TO A DISEASE OR DISABILITY, OR TO BE ASSO-
CIATED WITH A STATISTICALLY SIGNIFICANT INCREASED RISK OF THE DEVELOP-
MENT OF A PHYSICAL OR MENTAL DISEASE OR DISABILITY; AND
(B) "GENETIC TESTING" SHALL MEAN A TEST FOR DETERMINING THE PRESENCE
OR ABSENCE OF AN INHERITED GENETIC CHARACTERISTIC IN AN INDIVIDUAL,
INCLUDING TESTS OF NUCLEIC ACIDS SUCH AS DNA, RNA AND MITOCHONDRIAL DNA,
CHROMOSOMES OR PROTEINS IN ORDER TO IDENTIFY A PREDISPOSING GENETIC
CHARACTERISTIC.
(2) ON AND AFTER SEPTEMBER FIRST, TWO THOUSAND FIFTEEN EVERY POLICY
DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH PROVIDES MEDICAL
COVERAGE THAT INCLUDES COVERAGE FOR PHYSICIAN SERVICES IN A PHYSICIAN'S
OFFICE AND EVERY POLICY WHICH PROVIDES MAJOR MEDICAL OR SIMILAR COMPRE-
HENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR GENETIC TESTING, AND
ANY SUBSEQUENT TREATMENT RESULTING FROM THE RESULTS OF SUCH TEST, OF
PERSONS WHO, IN THE OPINION OF AN ATTENDING PHYSICIAN ARE PERSONS WITH A
SIGNIFICANT RISK OF CONTRACTING CANCER. FOR PURPOSES OF THIS SECTION, A
PERSON SHALL BE DEEMED TO HAVE A SIGNIFICANT RISK IF THERE IS A FAMILY
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05527-01-5
A. 318 2
HISTORY OF CANCER, MORE THAN ONE GENERATION IN SUCH FAMILY HAS HAD
CANCER, A FAMILY MEMBER HAS HAD MORE THAN ONE OCCURRENCE OF CANCER OR A
FAMILY MEMBER LESS THAN FORTY-FIVE YEARS OF AGE HAS BEEN DIAGNOSED WITH
CANCER. NOTHING IN THIS SUBSECTION SHALL BE DEEMED TO AUTHORIZE AN
INSURER TO UTILIZE OR RELEASE THE RESULTS OF SUCH TEST FOR ANY OTHER
PURPOSE. NO POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE PURSU-
ANT TO THIS ARTICLE, SHALL BE DENIED OR CANCELLED ON THE BASIS OF A
PREDISPOSING GENETIC CHARACTERISTIC.
S 2. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 11-b to read as follows:
(11-B) (A) (I) FOR PURPOSES OF THIS PARAGRAPH: "PREDISPOSING GENETIC
CHARACTERISTIC" SHALL MEAN ANY INHERITED GENE OR CHROMOSOME, OR ALTER-
ATION THEREOF, AND DETERMINED BY A GENETIC TEST OR INFERRED FROM INFOR-
MATION DERIVED FROM AN INDIVIDUAL OR FAMILY MEMBER THAT IS SCIENTIF-
ICALLY OR MEDICALLY BELIEVED TO PREDISPOSE AN INDIVIDUAL OR THE
OFFSPRING OF THAT INDIVIDUAL TO A DISEASE OR DISABILITY, OR TO BE ASSO-
CIATED WITH A STATISTICALLY SIGNIFICANT INCREASED RISK OF THE DEVELOP-
MENT OF A PHYSICAL OR MENTAL DISEASE OR DISABILITY; AND
(II) "GENETIC TESTING" SHALL MEAN A TEST FOR DETERMINING THE PRESENCE
OR ABSENCE OF AN INHERITED GENETIC CHARACTERISTIC IN AN INDIVIDUAL,
INCLUDING TESTS OF NUCLEIC ACIDS SUCH AS DNA, RNA AND MITOCHONDRIAL DNA,
CHROMOSOMES OR PROTEINS IN ORDER TO IDENTIFY A PREDISPOSING GENETIC
CHARACTERISTIC.
(B) ON AND AFTER SEPTEMBER FIRST, TWO THOUSAND FIFTEEN EVERY POLICY
DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH PROVIDES MEDICAL
COVERAGE THAT INCLUDES COVERAGE FOR PHYSICIAN SERVICES IN A PHYSICIAN'S
OFFICE AND MAJOR MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL
PROVIDE COVERAGE FOR GENETIC TESTING, AND ANY SUBSEQUENT TREATMENT
RESULTING FROM THE RESULTS OF SUCH TEST, OF PERSONS WHO, IN THE OPINION
OF AN ATTENDING PHYSICIAN ARE PERSONS WITH A SIGNIFICANT RISK OF
CONTRACTING CANCER. FOR PURPOSES OF THIS SECTION, A PERSON SHALL BE
DEEMED TO HAVE A SIGNIFICANT RISK IF THERE IS A FAMILY HISTORY OF
CANCER, MORE THAN ONE GENERATION IN SUCH FAMILY HAS HAD CANCER, A FAMILY
MEMBER HAS HAD MORE THAN ONE OCCURRENCE OF CANCER OR A FAMILY MEMBER
LESS THAN FORTY-FIVE YEARS OF AGE HAS BEEN DIAGNOSED WITH CANCER. NOTH-
ING IN THIS PARAGRAPH SHALL BE DEEMED TO AUTHORIZE AN INSURER TO UTILIZE
OR RELEASE THE RESULTS OF SUCH TEST FOR ANY OTHER PURPOSE. NO POLICY
DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE PURSUANT TO THIS ARTICLE,
SHALL BE DENIED OR CANCELLED ON THE BASIS OF A PREDISPOSING GENETIC
CHARACTERISTIC.
S 3. Section 4303 of the insurance law is amended by adding a new
subsection (oo) to read as follows:
(OO) (1) (A) FOR PURPOSES OF THIS SUBSECTION: "PREDISPOSING GENETIC
CHARACTERISTIC" SHALL MEAN ANY INHERITED GENE OR CHROMOSOME, OR ALTER-
ATION THEREOF, AND DETERMINED BY A GENETIC TEST OR INFERRED FROM INFOR-
MATION DERIVED FROM AN INDIVIDUAL OR FAMILY MEMBER THAT IS SCIENTIF-
ICALLY OR MEDICALLY BELIEVED TO PREDISPOSE AN INDIVIDUAL OR THE
OFFSPRING OF THAT INDIVIDUAL TO A DISEASE OR DISABILITY, OR TO BE ASSO-
CIATED WITH A STATISTICALLY SIGNIFICANT INCREASED RISK OF THE DEVELOP-
MENT OF A PHYSICAL OR MENTAL DISEASE OR DISABILITY; AND
(B) "GENETIC TESTING" SHALL MEAN A TEST FOR DETERMINING THE PRESENCE
OR ABSENCE OF AN INHERITED GENETIC CHARACTERISTIC IN AN INDIVIDUAL,
INCLUDING TESTS OF NUCLEIC ACIDS SUCH AS DNA, RNA AND MITOCHONDRIAL DNA,
CHROMOSOMES OR PROTEINS IN ORDER TO IDENTIFY A PREDISPOSING GENETIC
CHARACTERISTIC.
A. 318 3
(2) ON AND AFTER SEPTEMBER FIRST, TWO THOUSAND FIFTEEN EVERY POLICY
DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE WHICH PROVIDES MEDICAL
COVERAGE THAT INCLUDES COVERAGE FOR PHYSICIAN SERVICES IN A PHYSICIAN'S
OFFICE OR MAJOR MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL
PROVIDE COVERAGE FOR GENETIC TESTING, AND ANY SUBSEQUENT TREATMENT
RESULTING FROM THE RESULTS OF SUCH TEST, OF PERSONS WHO, IN THE OPINION
OF AN ATTENDING PHYSICIAN ARE PERSONS WITH A SIGNIFICANT RISK OF
CONTRACTING CANCER. FOR PURPOSES OF THIS SECTION, A PERSON SHALL BE
DEEMED TO HAVE A SIGNIFICANT RISK IF THERE IS A FAMILY HISTORY OF
CANCER, MORE THAN ONE GENERATION IN SUCH FAMILY HAS HAD CANCER, A FAMILY
MEMBER HAS HAD MORE THAN ONE OCCURRENCE OF CANCER OR A FAMILY MEMBER
LESS THAN FORTY-FIVE YEARS OF AGE HAS BEEN DIAGNOSED WITH CANCER. NOTH-
ING IN THIS SUBSECTION SHALL BE DEEMED TO AUTHORIZE AN INSURER TO
UTILIZE OR RELEASE THE RESULTS OF SUCH TEST FOR ANY OTHER PURPOSE. NO
POLICY DELIVERED OR ISSUED FOR DELIVERY IN THIS STATE PURSUANT TO THIS
ARTICLE, SHALL BE DENIED OR CANCELLED ON THE BASIS OF A PREDISPOSING
GENETIC CHARACTERISTIC.
S 4. This act shall take effect immediately.