S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2883--A
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 28, 2019
                                ___________
 
 Introduced  by  M. of A. DINOWITZ, GALEF, CUSICK, CYMBROWITZ, ZEBROWSKI,
   ORTIZ, ENGLEBRIGHT, ROZIC -- Multi-Sponsored by -- M. of A.  BARNWELL,
   CAHILL,  COLTON,  COOK,  GLICK, GOTTFRIED -- read once and referred to
   the Committee on Insurance -- recommitted to the Committee  on  Insur-
   ance  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 36, 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 37, paragraph 34 of subsection (i) of section  3216
 of the insurance law, as added by section 10 of part MM of chapter 57 of
 the  laws  of 2018, is renumbered paragraph 38 and a new paragraph 39 is
 added to read as follows:
   (39) (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 THIRTY-FIVE  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;

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

                                                            LBD00642-04-0

 A. 2883--A                          2
 
   (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.
   § 2. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 22 to read as follows:
   (22) (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 THIRTY-FIVE 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.
   § 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 THIRTY-FIVE 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  PHYSI-
 CIAN  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.
   § 4. The superintendent of financial services shall require an  insur-
 er,  health  carrier or health benefit plan to notify enrollees annually

 A. 2883--A                          3
 
 of colorectal cancer screenings covered by such enrollees' health  bene-
 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.
   § 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.