S T A T E O F N E W Y O R K
________________________________________________________________________
2936
2019-2020 Regular Sessions
I N A S S E M B L Y
January 28, 2019
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Introduced by M. of A. SOLAGES, BUCHWALD -- read once and referred to
the Committee on Insurance
AN ACT to amend the insurance law, in relation to providing for health
insurance coverage for diagnostic screening for colorectal cancer
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subsection (i) of section 3216 of the insurance law is
amended by adding a new paragraph 11-b to read as follows:
(11-B) (A) 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 COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE, UPON THE
PRESCRIPTION OF A HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE
UNDER TITLE EIGHT OF THE EDUCATION LAW, THE FOLLOWING COVERAGE FOR DIAG-
NOSTIC SCREENING FOR COLORECTAL CANCER:
(I) STANDARD DIAGNOSTIC TESTING INCLUDING, BUT NOT LIMITED TO, A
DIGITAL RECTAL EXAMINATION AT ANY AGE FOR PEOPLE HAVING A FAMILY HISTORY
OF COLORECTAL CANCER OR A PERSONAL HISTORY OF POLYPS OR INFLAMMATORY
BOWEL DISEASE; AND
(II) AN ANNUAL STANDARD DIAGNOSTIC EXAMINATION INCLUDING, BUT NOT
LIMITED TO, A DIGITAL RECTAL EXAMINATION FOR PEOPLE AGE FIFTY AND OVER
WHO ARE ASYMPTOMATIC AND FOR PEOPLE AGE FORTY AND OVER WITH A FAMILY
HISTORY OF COLORECTAL CANCER OR OTHER COLORECTAL CANCER RISK FACTORS.
(B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
§ 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) 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
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05021-01-9
A. 2936 2
MEDICAL OR SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE, UPON THE
PRESCRIPTION OF A HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE
UNDER TITLE EIGHT OF THE EDUCATION LAW, THE FOLLOWING COVERAGE FOR DIAG-
NOSTIC SCREENING FOR COLORECTAL CANCER:
(I) STANDARD DIAGNOSTIC TESTING INCLUDING, BUT NOT LIMITED TO, A
DIGITAL RECTAL EXAMINATION AT ANY AGE FOR PEOPLE HAVING A FAMILY HISTORY
OF COLORECTAL CANCER OR A PERSONAL HISTORY OF POLYPS OR INFLAMMATORY
BOWEL DISEASE; AND
(II) AN ANNUAL STANDARD DIAGNOSTIC EXAMINATION INCLUDING, BUT NOT
LIMITED TO, A DIGITAL RECTAL EXAMINATION FOR PEOPLE AGE FIFTY AND OVER
WHO ARE ASYMPTOMATIC AND FOR PEOPLE AGE FORTY AND OVER WITH A FAMILY
HISTORY OF COLORECTAL CANCER OR OTHER COLORECTAL CANCER RISK FACTORS.
(B) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
§ 3. Section 4303 of the insurance law is amended by adding a new
subsection (z-2) to read as follows:
(Z-2) (1) 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 COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE, UPON THE
PRESCRIPTION OF A HEALTH CARE PROVIDER LEGALLY AUTHORIZED TO PRESCRIBE
UNDER TITLE EIGHT OF THE EDUCATION LAW, THE FOLLOWING COVERAGE FOR DIAG-
NOSTIC SCREENING FOR COLORECTAL CANCER:
(A) STANDARD DIAGNOSTIC TESTING INCLUDING, BUT NOT LIMITED TO, A
DIGITAL RECTAL EXAMINATION AT ANY AGE FOR PEOPLE HAVING A FAMILY HISTORY
OF COLORECTAL CANCER OR A PERSONAL HISTORY OF POLYPS OR INFLAMMATORY
BOWEL DISEASE; AND
(B) AN ANNUAL STANDARD DIAGNOSTIC EXAMINATION INCLUDING, BUT NOT
LIMITED TO, A DIGITAL RECTAL EXAMINATION FOR PEOPLE AGE FIFTY AND OVER
WHO ARE ASYMPTOMATIC AND FOR PEOPLE AGE FORTY AND OVER WITH A FAMILY
HISTORY OF COLORECTAL CANCER OR OTHER COLORECTAL CANCER RISK FACTORS.
(2) SUCH COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND COINSURANCE
AS MAY BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS ARE CONSISTENT
WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN POLICY.
§ 4. This act shall take effect on the first of January next succeed-
ing the date on which it shall have become a law.