S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5651
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 14, 2019
                                ___________
 
 Introduced by M. of A. ROZIC, PEOPLES-STOKES, AUBRY, ABINANTI, BARNWELL,
   BLAKE,  COLTON,  COOK,  CRESPO,  D'URSO, GUNTHER, JAFFEE, JONES, OTIS,
   PERRY, SIMON, STECK, TITUS, WEPRIN, MONTESANO,  M. G. MILLER  --  read
   once and referred to the Committee on Insurance
 
 AN  ACT  to  amend  the  insurance  law, in relation to requiring health
   insurance policies to cover comprehensive tests for ovarian cancer  in
   certain cases
 
   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 THAT PROVIDES COVERAGE FOR HOSPITAL, SURGICAL
 OR MEDICAL CARE SHALL PROVIDE THE FOLLOWING COVERAGE FOR  SCREENING  FOR
 OVARIAN CANCER:
   (I)  UPON  THE  RECOMMENDATION  OF A PHYSICIAN, A PELVIC EXAM, GENETIC
 TESTING, ULTRASOUND AND BLOOD TESTING AT ANY  AGE  FOR  COVERED  PERSONS
 HAVING  A  HIGH  RISK  OF  DEVELOPING OVARIAN CANCER OR WHO HAVE A FIRST
 DEGREE RELATIVE WITH A PRIOR HISTORY OF OVARIAN CANCER;
   (II) A SINGLE BASELINE ULTRASOUND FOR COVERED PERSONS AGED THIRTY-FIVE
 THROUGH THIRTY-NINE, INCLUSIVE; AND
   (III) AN ANNUAL ULTRASOUND FOR COVERED PERSONS AGED FORTY AND OLDER.
   (B) SUCH COVERAGE REQUIRED PURSUANT TO SUBPARAGRAPH (A) OF THIS  PARA-
 GRAPH  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.
   (C) (I) SUCH POLICY SHALL PROVIDE FOR ADDITIONAL COVERAGE FOR COMPUTED
 TOMOGRAPHY, BARIUM ENEMA X-RAYS, MAGNETIC RESONANCE IMAGING (MRI), POSI-
 TRON  EMISSION  TOMOGRAPHY,  LAPAROSCOPY,  COLONOSCOPY  AND  BIOPSY IF A
 PERSON IS BELIEVED TO BE AT INCREASED RISK FOR  OVARIAN  CANCER  DUE  TO
 FAMILY  HISTORY  OR  PRIOR  PERSONAL HISTORY OF OVARIAN CANCER, POSITIVE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01112-01-9
              

 A. 5651                             2
 
 GENETIC TESTING OR OTHER INDICATIONS  AS  DETERMINED  BY  SUCH  PERSON'S
 PHYSICIAN OR NURSE PRACTITIONER.
   (II) SUCH ADDITIONAL 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 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  THE
 FOLLOWING COVERAGE FOR SCREENING FOR OVARIAN CANCER:
   (I)  UPON  THE  RECOMMENDATION  OF A PHYSICIAN, A PELVIC EXAM, GENETIC
 TESTING, ULTRASOUND AND BLOOD TESTING AT ANY  AGE  FOR  COVERED  PERSONS
 HAVING  A  HIGH  RISK  OF  DEVELOPING OVARIAN CANCER OR WHO HAVE A FIRST
 DEGREE RELATIVE WITH A PRIOR HISTORY OF OVARIAN CANCER;
   (II) A SINGLE BASELINE ULTRASOUND FOR COVERED PERSONS AGED THIRTY-FIVE
 THROUGH THIRTY-NINE, INCLUSIVE; AND
   (III) AN ANNUAL ULTRASOUND FOR COVERED PERSONS AGED FORTY AND OLDER.
   (B) SUCH COVERAGE REQUIRED PURSUANT TO SUBPARAGRAPH (A) OF THIS  PARA-
 GRAPH  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.
   (C) (I) SUCH POLICY SHALL PROVIDE FOR ADDITIONAL COVERAGE FOR COMPUTED
 TOMOGRAPHY, BARIUM ENEMA X-RAYS, MAGNETIC RESONANCE IMAGING (MRI), POSI-
 TRON  EMISSION  TOMOGRAPHY,  LAPAROSCOPY,  COLONOSCOPY  AND  BIOPSY IF A
 PERSON IS BELIEVED TO BE AT INCREASED RISK FOR  OVARIAN  CANCER  DUE  TO
 FAMILY  HISTORY  OR  PRIOR  PERSONAL HISTORY OF OVARIAN CANCER, POSITIVE
 GENETIC TESTING OR OTHER INDICATIONS  AS  DETERMINED  BY  SUCH  PERSON'S
 PHYSICIAN OR NURSE PRACTITIONER.
   (II) SUCH ADDITIONAL 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 (p-1) 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 THE FOLLOWING  COVERAGE
 FOR SCREENING FOR OVARIAN CANCER:
   (A)  UPON  THE  RECOMMENDATION  OF A PHYSICIAN, A PELVIC EXAM, GENETIC
 TESTING, ULTRASOUND AND BLOOD TESTING AT ANY  AGE  FOR  COVERED  PERSONS
 HAVING  A  HIGH  RISK  OF  DEVELOPING OVARIAN CANCER OR WHO HAVE A FIRST
 DEGREE RELATIVE WITH A PRIOR HISTORY OF OVARIAN CANCER;
   (B) A SINGLE BASELINE ULTRASOUND FOR COVERED PERSONS AGED  THIRTY-FIVE
 THROUGH THIRTY-NINE, INCLUSIVE; AND
   (C) AN ANNUAL ULTRASOUND FOR COVERED PERSONS AGED FORTY AND OLDER.
   (2)  SUCH COVERAGE REQUIRED PURSUANT TO SUBPARAGRAPH (A) OF THIS PARA-
 GRAPH 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) (A) SUCH POLICY SHALL PROVIDE FOR ADDITIONAL COVERAGE FOR COMPUTED
 TOMOGRAPHY, BARIUM ENEMA X-RAYS, MAGNETIC RESONANCE IMAGING (MRI), POSI-
 TRON EMISSION TOMOGRAPHY,  LAPAROSCOPY,  COLONOSCOPY  AND  BIOPSY  IF  A
 PERSON  IS  BELIEVED  TO  BE AT INCREASED RISK FOR OVARIAN CANCER DUE TO
 FAMILY HISTORY OR PRIOR PERSONAL HISTORY  OF  OVARIAN  CANCER,  POSITIVE

 A. 5651                             3
 
 GENETIC  TESTING  OR  OTHER  INDICATIONS  AS DETERMINED BY SUCH PERSON'S
 PHYSICIAN OR NURSE PRACTITIONER.
   (B)  SUCH ADDITIONAL 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 sixtieth  day  after  it  shall
 have become a law.