S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3797
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 31, 2019
                                ___________
 
 Introduced  by  M.  of  A. ORTIZ, COOK, COLTON, GUNTHER, PEOPLES-STOKES,
   CAHILL, ENGLEBRIGHT, M. G. MILLER -- Multi-Sponsored by --  M.  of  A.
   GOTTFRIED,  LUPARDO, RIVERA -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the insurance law, in relation to providing coverage for
   surveillance tests for ovarian 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 35 to read as follows:
   (35) EVERY POLICY THAT  PROVIDES  MEDICAL,  MAJOR-MEDICAL  OR  SIMILAR
 COMPREHENSIVE-TYPE  COVERAGE  SHALL  PROVIDE  COVERAGE  FOR SURVEILLANCE
 TESTS FOR OVARIAN CANCER FOR AN INSURED  WHO  IS  AT  RISK  FOR  OVARIAN
 CANCER.  (A) FOR PURPOSES OF THIS SUBSECTION, AN INSURED IS DEEMED TO BE
 AT RISK IF:
   (I) SHE HAS A FAMILY HISTORY OF:
   1. ONE OR MORE FIRST-DEGREE RELATIVE WITH OVARIAN CANCER;
   2. THREE OR MORE FEMALE RELATIVES WITH BREAST CANCER; OR
   3. NONPOLYPOSIS COLORECTAL CANCER; OR
   (II) SHE TESTS POSITIVE FOR BRCA1 OR BRCA2 MUTATIONS.
   (B) FOR PURPOSES OF THIS SUBSECTION, SURVEILLANCE  TESTS  FOR  OVARIAN
 CANCER SHALL MEAN ANNUAL SCREENING FOR OVARIAN CANCER USING:
   (I) CA-125 SERUM TUMOR MARKER TESTING;
   (II) TRANSVAGINAL ULTRASOUND; AND
   (III) PELVIC EXAMINATION.
   § 2. Subsection (k) of section 3221 of the insurance law is amended by
 adding a new paragraph 22 to read as follows:
   (22) EVERY GROUP OR BLANKET POLICY DELIVERED OR ISSUED FOR DELIVERY IN
 THIS  STATE  WHICH PROVIDES HOSPITAL, SURGICAL OR MEDICAL COVERAGE SHALL
 INCLUDE COVERAGE FOR  SURVEILLANCE  TESTS  FOR  OVARIAN  CANCER  FOR  AN
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08249-01-9
              

 A. 3797                             2
 
 INSURED  WHO  IS  AT  RISK  FOR OVARIAN CANCER. (A) FOR PURPOSES OF THIS
 SUBSECTION, AN INSURED IS DEEMED TO BE AT RISK IF:
   (I) SHE HAS A FAMILY HISTORY OF:
   1. ONE OR MORE FIRST-DEGREE RELATIVE WITH OVARIAN CANCER;
   2. THREE OR MORE FEMALE RELATIVES WITH BREAST CANCER; OR
   3. NONPOLYPOSIS COLORECTAL CANCER; OR
   (II) SHE TESTS POSITIVE FOR BRCA1 OR BRCA2 MUTATIONS.
   (B)  FOR  PURPOSES  OF THIS SUBSECTION, SURVEILLANCE TESTS FOR OVARIAN
 CANCER SHALL MEAN ANNUAL SCREENING FOR OVARIAN CANCER USING:
   (I) CA-125 SERUM TUMOR MARKER TESTING;
   (II) TRANSVAGINAL ULTRASOUND; AND
   (III) PELVIC EXAMINATION.
   § 3. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (ss) to read as follows:
   (SS)  A HEALTH SERVICE CORPORATION OR MEDICAL EXPENSE INDEMNITY CORPO-
 RATION WHICH PROVIDES MEDICAL, MAJOR-MEDICAL OR  SIMILAR  COMPREHENSIVE-
 TYPE  COVERAGE  MUST PROVIDE COVERAGE FOR SURVEILLANCE TESTS FOR OVARIAN
 CANCER FOR AN INSURED WHO  IS  AT  RISK  FOR  OVARIAN  CANCER.  (1)  FOR
 PURPOSES OF THIS SUBSECTION, AN INSURED IS DEEMED TO BE AT RISK IF:
   (A) SHE HAS A FAMILY HISTORY OF:
   (I) ONE OR MORE FIRST-DEGREE RELATIVE WITH OVARIAN CANCER;
   (II) THREE OR MORE FEMALE RELATIVES WITH BREAST CANCER; OR
   (III) NONPOLYPOSIS COLORECTAL CANCER; OR
   (B) SHE TESTS POSITIVE FOR BRCA1 OR BRCA2 MUTATIONS.
   (2)  FOR  PURPOSES  OF THIS SUBSECTION, SURVEILLANCE TESTS FOR OVARIAN
 CANCER SHALL MEAN ANNUAL SCREENING FOR OVARIAN CANCER USING:
   (A) CA-125 SERUM TUMOR MARKER TESTING;
   (B) TRANSVAGINAL ULTRASOUND; AND
   (C) PELVIC EXAMINATION.
   § 4. This act shall take effect immediately and  shall  apply  to  any
 policy issued, renewed, or modified after such effective date.