S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   3321
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                             February 5, 2019
                                ___________
 
 Introduced  by  Sen. LAVALLE -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance law,  in  relation  to  requiring  certain
   health insurance coverage for lymphedema
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1.  Clause  (ii)  of  subparagraph  (A)  of  paragraph  20  of
 subsection (i) of section 3216 of the insurance law, as added by chapter
 21  of  the  laws of 1997, is amended and a new clause (iii) is added to
 read as follows:
   (ii) surgery and reconstruction of  the  other  breast  to  produce  a
 symmetrical appearance; AND
   (III) PROSTHESES AND PHYSICAL COMPLICATIONS OF ALL STAGES OF MASTECTO-
 MY, INCLUDING LYMPHEDEMA;
   § 2. Subsection (i) of section 3216 of the insurance law is amended by
 adding two new paragraphs 35 and 36 to read as follows:
   (35)  EVERY POLICY WHICH PROVIDES HOSPITAL, SURGICAL, MEDICAL OR MAJOR
 MEDICAL COVERAGE SHALL PROVIDE COVERAGE FOR THE  DIFFERENTIAL  DIAGNOSIS
 AND TREATMENT OF LYMPHEDEMA. SUCH COVERAGE SHALL INCLUDE, IN ADDITION TO
 BENEFITS FOR A COURSE OF MANUAL LYMPH DRAINAGE WHOSE FREQUENCY AND DURA-
 TION  IS  DETERMINED  BY  THE  TREATING  PHYSICIAN OR THERAPIST BASED ON
 MEDICAL NECESSITY AND NOT BASED ON PHYSICAL THERAPY  AND  REHABILITATION
 STANDARDS,  BENEFITS FOR EQUIPMENT, SUPPLIES, DEVICES, COMPLEX DECONGES-
 TIVE THERAPY, AND OUT-PATIENT SELF-MANAGEMENT TRAINING AND EDUCATION FOR
 THE TREATMENT OF LYMPHEDEMA, IF PRESCRIBED BY A HEALTH CARE PROFESSIONAL
 LEGALLY AUTHORIZED TO PRESCRIBE OR PROVIDE SUCH ITEMS UNDER TITLE  EIGHT
 OF  THE  EDUCATION  LAW.    LYMPHEDEMA  THERAPY  ADMINISTERED UNDER THIS
 SECTION SHALL BE ADMINISTERED ONLY BY A THERAPIST CERTIFIED  TO  PERFORM
 LYMPHEDEMA  TREATMENT  BY  THE  LYMPHOLOGY  ASSOCIATION OF NORTH AMERICA
 (LANA) OR CERTIFIED IN  ACCORDANCE  WITH  STANDARDS  EQUIVALENT  TO  THE
 CERTIFICATION  STANDARDS  OF LANA.   SUCH EQUIPMENT, SUPPLIES OR DEVICES
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD02513-01-9

 S. 3321                             2
 
 SHALL INCLUDE, BUT NOT BE LIMITED TO,  BANDAGES,  COMPRESSION  GARMENTS,
 PADS,  ORTHOTIC  SHOES  AND  DEVICES, WITH REPLACEMENTS WHEN REQUIRED TO
 MAINTAIN COMPRESSIVE FUNCTION OR TO ACCOMMODATE CHANGES IN THE PATIENT'S
 DIMENSIONS.  COVERAGE  SHALL  BE  PROVIDED FOR FOLLOW-UP TREATMENTS WHEN
 MEDICALLY REQUIRED OR TO PERIODICALLY VALIDATE HOME TECHNIQUES, TO MONI-
 TOR PROGRESS AGAINST THE WRITTEN TREATMENT PLAN AND TO MODIFY THE TREAT-
 MENT PLAN AS REQUIRED. NO INDIVIDUAL, OTHER THAN A LICENSED PHYSICIAN OR
 SURGEON COMPETENT TO EVALUATE THE SPECIFIC CLINICAL ISSUES  INVOLVED  IN
 THE  CARE  REQUESTED, MAY DENY REQUESTS FOR AUTHORIZATION OF HEALTH CARE
 SERVICES PURSUANT TO THIS SECTION.
   (A) A POLICY WHICH IS A MANAGED HEALTH CARE PRODUCT MAY  REQUIRE  SUCH
 HEALTH  CARE PROFESSIONAL BE A MEMBER OF SUCH MANAGED HEALTH CARE PLAN'S
 PROVIDER NETWORK, PROVIDED THAT SUCH NETWORK INCLUDES SUFFICIENT  HEALTH
 CARE  PROFESSIONALS  WHO ARE QUALIFIED BY SPECIFIC EDUCATION, EXPERIENCE
 AND CREDENTIALS TO PROVIDE THE COVERED BENEFITS DESCRIBED IN THIS  PARA-
 GRAPH.
   (B)  NO INSURER, CORPORATION, OR HEALTH MAINTENANCE ORGANIZATION SHALL
 IMPOSE UPON ANY PERSON RECEIVING BENEFITS PURSUANT TO THIS PARAGRAPH ANY
 COPAYMENT, FEE, POLICY YEAR OR  CALENDAR  YEAR,  OR  DURATIONAL  BENEFIT
 LIMITATION  OR  MAXIMUM  FOR  BENEFITS  OR  SERVICES THAT IS NOT EQUALLY
 IMPOSED UPON ALL INDIVIDUALS IN THE SAME BENEFIT CATEGORY.
   (C) THIS PARAGRAPH SHALL NOT  APPLY  TO  SHORT-TERM  TRAVEL,  ACCIDENT
 ONLY, LIMITED OR SPECIFIED DISEASE, OR INDIVIDUAL CONVERSION POLICIES OR
 CONTRACTS, NOR TO POLICIES OR CONTRACTS DESIGNED FOR ISSUANCE TO PERSONS
 ELIGIBLE  FOR  COVERAGE  UNDER  TITLE  XVIII OF THE SOCIAL SECURITY ACT,
 KNOWN AS MEDICARE, OR ANY OTHER SIMILAR COVERAGE UNDER STATE OR  FEDERAL
 GOVERNMENTAL PLANS.
   (D)  FOR  PURPOSES  OF  THIS PARAGRAPH, A "MANAGED CARE PRODUCT" SHALL
 MEAN A POLICY WHICH REQUIRES THAT MEDICAL OR OTHER HEALTH CARE  SERVICES
 COVERED  UNDER  THE  POLICY,  OTHER  THAN  EMERGENCY  CARE  SERVICES, BE
 PROVIDED BY, OR PURSUANT TO A REFERRAL FROM A PRIMARY CARE PROVIDER, AND
 THAT SERVICES PROVIDED PURSUANT TO SUCH A  REFERRAL  BE  RENDERED  BY  A
 HEALTH CARE PROVIDER PARTICIPATING IN THE INSURER'S MANAGED CARE PROVID-
 ER  NETWORK.  IN  ADDITION,  A  MANAGED CARE PRODUCT SHALL ALSO MEAN THE
 IN-NETWORK PORTION OF A CONTRACT WHICH REQUIRES THAT  MEDICAL  OR  OTHER
 HEALTH  CARE  SERVICES  COVERED UNDER THE CONTRACT, OTHER THAN EMERGENCY
 CARE SERVICES, BE PROVIDED BY, OR PURSUANT TO A REFERRAL FROM A  PRIMARY
 CARE PROVIDER, AND THAT SERVICES PROVIDED PURSUANT TO SUCH A REFERRAL BE
 RENDERED  BY  A  HEALTH  CARE  PROVIDER  PARTICIPATING  IN THE INSURER'S
 MANAGED CARE PROVIDER NETWORK, IN ORDER FOR THE INSURED TO  BE  ENTITLED
 TO THE MAXIMUM REIMBURSEMENT UNDER THE CONTRACT.
   (36)  PATIENTS  UNDERGOING ANY SURGERY OR RADIOTHERAPY PROCEDURE SHALL
 BE PROVIDED INFORMATION ON THE RISK OF LYMPHEDEMA ASSOCIATED  WITH  THAT
 PROCEDURE,  AND  THE  POTENTIAL  POST-PROCEDURE  SYMPTOMS OF LYMPHEDEMA.
 INFORMED CONSENT AGREEMENTS FOR ALL SURGERIES  AND  RADIATION  THERAPIES
 SHALL  INCLUDE INFORMATION ON THE RISK OF LYMPHEDEMA ASSOCIATED WITH THE
 ALTERNATIVE PROCEDURES.
   § 3. Clause (ii) of subparagraph (A) of paragraph 10 of subsection (k)
 of section 3221 of the insurance law, as added by chapter 21 of the laws
 of 1997, is amended and a new clause (iii) is added to read as follows:
   (ii) surgery and reconstruction of  the  other  breast  to  produce  a
 symmetrical appearance; AND
   (III) PROSTHESES AND PHYSICAL COMPLICATIONS OF ALL STAGES OF MASTECTO-
 MY, INCLUDING LYMPHEDEMA;
   § 4. Subsection (k) of section 3221 of the insurance law is amended by
 adding two new paragraphs 22 and 23 to read as follows:

 S. 3321                             3
 
   (22)  EVERY  GROUP  POLICY ISSUED OR ISSUED FOR DELIVERY IN THIS STATE
 WHICH PROVIDES HOSPITAL, SURGICAL, MEDICAL  OR  MAJOR  MEDICAL  COVERAGE
 SHALL  PROVIDE  COVERAGE FOR THE DIFFERENTIAL DIAGNOSIS AND TREATMENT OF
 LYMPHEDEMA. SUCH COVERAGE SHALL INCLUDE, IN ADDITION TO BENEFITS  FOR  A
 COURSE  OF  MANUAL LYMPH DRAINAGE WHOSE FREQUENCY AND DURATION IS DETER-
 MINED BY THE TREATING PHYSICIAN OR THERAPIST BASED ON MEDICAL  NECESSITY
 AND NOT BASED ON PHYSICAL THERAPY AND REHABILITATION STANDARDS, BENEFITS
 FOR  EQUIPMENT,  SUPPLIES,  DEVICES,  COMPLEX  DECONGESTIVE THERAPY, AND
 OUT-PATIENT SELF-MANAGEMENT TRAINING AND EDUCATION FOR THE TREATMENT  OF
 LYMPHEDEMA,  IF PRESCRIBED BY A HEALTH CARE PROFESSIONAL LEGALLY AUTHOR-
 IZED TO PRESCRIBE OR PROVIDE SUCH ITEMS UNDER TITLE EIGHT OF THE  EDUCA-
 TION  LAW.   LYMPHEDEMA THERAPY ADMINISTERED UNDER THIS SECTION SHALL BE
 ADMINISTERED ONLY BY A THERAPIST CERTIFIED TO PERFORM LYMPHEDEMA  TREAT-
 MENT  BY THE LYMPHOLOGY ASSOCIATION OF NORTH AMERICA (LANA) OR CERTIFIED
 IN ACCORDANCE WITH STANDARDS EQUIVALENT TO THE  CERTIFICATION  STANDARDS
 OF  LANA.  SUCH EQUIPMENT, SUPPLIES OR DEVICES SHALL INCLUDE, BUT NOT BE
 LIMITED TO, BANDAGES, COMPRESSION GARMENTS,  PADS,  ORTHOTIC  SHOES  AND
 DEVICES,  WITH  REPLACEMENTS WHEN REQUIRED TO MAINTAIN COMPRESSIVE FUNC-
 TION OR TO ACCOMMODATE CHANGES IN  THE  PATIENT'S  DIMENSIONS.  COVERAGE
 SHALL BE PROVIDED FOR FOLLOW-UP TREATMENTS WHEN MEDICALLY REQUIRED OR TO
 PERIODICALLY  VALIDATE  HOME TECHNIQUES, TO MONITOR PROGRESS AGAINST THE
 WRITTEN TREATMENT PLAN AND TO MODIFY THE TREATMENT PLAN AS REQUIRED.  NO
 INDIVIDUAL,  OTHER  THAN  A  LICENSED  PHYSICIAN OR SURGEON COMPETENT TO
 EVALUATE THE SPECIFIC CLINICAL ISSUES INVOLVED IN  THE  CARE  REQUESTED,
 MAY  DENY REQUESTS FOR AUTHORIZATION OF HEALTH CARE SERVICES PURSUANT TO
 THIS SECTION.
   (A) A POLICY WHICH IS A MANAGED HEALTH CARE PRODUCT MAY  REQUIRE  SUCH
 HEALTH  CARE PROFESSIONAL BE A MEMBER OF SUCH MANAGED HEALTH CARE PLAN'S
 PROVIDER NETWORK, PROVIDED THAT SUCH NETWORK INCLUDES SUFFICIENT  HEALTH
 CARE  PROFESSIONALS  WHO ARE QUALIFIED BY SPECIFIC EDUCATION, EXPERIENCE
 AND CREDENTIALS TO PROVIDE THE COVERED BENEFITS DESCRIBED IN THIS  PARA-
 GRAPH.
   (B)  NO INSURER, CORPORATION, OR HEALTH MAINTENANCE ORGANIZATION SHALL
 IMPOSE UPON ANY PERSON RECEIVING BENEFITS PURSUANT TO THIS PARAGRAPH ANY
 COPAYMENT, FEE, POLICY YEAR OR  CALENDAR  YEAR,  OR  DURATIONAL  BENEFIT
 LIMITATION  OR  MAXIMUM  FOR  BENEFITS  OR  SERVICES THAT IS NOT EQUALLY
 IMPOSED UPON ALL INDIVIDUALS IN THE SAME BENEFIT CATEGORY.
   (C) THIS PARAGRAPH SHALL NOT  APPLY  TO  SHORT-TERM  TRAVEL,  ACCIDENT
 ONLY, LIMITED OR SPECIFIED DISEASE, OR INDIVIDUAL CONVERSION POLICIES OR
 CONTRACTS, NOR TO POLICIES OR CONTRACTS DESIGNED FOR ISSUANCE TO PERSONS
 ELIGIBLE  FOR  COVERAGE  UNDER  TITLE  XVIII OF THE SOCIAL SECURITY ACT,
 KNOWN AS MEDICARE, OR ANY OTHER SIMILAR COVERAGE UNDER STATE OR  FEDERAL
 GOVERNMENTAL PLANS.
   (D)  FOR  PURPOSES  OF  THIS PARAGRAPH, A "MANAGED CARE PRODUCT" SHALL
 MEAN A POLICY WHICH REQUIRES THAT MEDICAL OR OTHER HEALTH CARE  SERVICES
 COVERED  UNDER  THE  POLICY,  OTHER  THAN  EMERGENCY  CARE  SERVICES, BE
 PROVIDED BY, OR PURSUANT TO A REFERRAL FROM A PRIMARY CARE PROVIDER, AND
 THAT SERVICES PROVIDED PURSUANT TO SUCH A  REFERRAL  BE  RENDERED  BY  A
 HEALTH CARE PROVIDER PARTICIPATING IN THE INSURER'S MANAGED CARE PROVID-
 ER  NETWORK.  IN  ADDITION,  A  MANAGED CARE PRODUCT SHALL ALSO MEAN THE
 IN-NETWORK PORTION OF A CONTRACT WHICH REQUIRES THAT  MEDICAL  OR  OTHER
 HEALTH  CARE  SERVICES  COVERED UNDER THE CONTRACT, OTHER THAN EMERGENCY
 CARE SERVICES, BE PROVIDED BY, OR PURSUANT TO A REFERRAL FROM A  PRIMARY
 CARE PROVIDER, AND THAT SERVICES PROVIDED PURSUANT TO SUCH A REFERRAL BE
 RENDERED  BY  A  HEALTH  CARE  PROVIDER  PARTICIPATING  IN THE INSURER'S

 S. 3321                             4
 
 MANAGED CARE PROVIDER NETWORK, IN ORDER FOR THE INSURED TO  BE  ENTITLED
 TO THE MAXIMUM REIMBURSEMENT UNDER THE CONTRACT.
    (23)  PATIENTS UNDERGOING ANY SURGERY OR RADIOTHERAPY PROCEDURE SHALL
 BE PROVIDED INFORMATION ON THE RISK OF LYMPHEDEMA ASSOCIATED  WITH  THAT
 PROCEDURE,  AND  THE  POTENTIAL  POST-PROCEDURE  SYMPTOMS OF LYMPHEDEMA.
 INFORMED CONSENT AGREEMENTS FOR ALL SURGERIES  AND  RADIATION  THERAPIES
 SHALL  INCLUDE INFORMATION ON THE RISK OF LYMPHEDEMA ASSOCIATED WITH THE
 ALTERNATIVE PROCEDURES.
   § 5. Subparagraph (B) of paragraph 1 of subsection (x) of section 4303
 of the insurance law, as added by chapter 21 of the  laws  of  1997,  is
 amended and a new subparagraph (C) is added to read as follows:
   (B)  surgery  and  reconstruction  of  the  other  breast to produce a
 symmetrical appearance; AND
   (C) PROSTHESES AND PHYSICAL COMPLICATIONS OF ALL STAGES OF MASTECTOMY,
 INCLUDING LYMPHEDEMA;
   § 6. Section 4303 of the insurance law is amended by  adding  two  new
 subsections (ss) and (tt) to read as follows:
   (SS) EVERY CONTRACT ISSUED BY A HOSPITAL SERVICE CORPORATION OR HEALTH
 SERVICE  CORPORATION WHICH PROVIDES HOSPITAL, SURGICAL, MEDICAL OR MAJOR
 MEDICAL COVERAGE SHALL PROVIDE COVERAGE FOR THE  DIFFERENTIAL  DIAGNOSIS
 AND TREATMENT OF LYMPHEDEMA. SUCH COVERAGE SHALL INCLUDE, IN ADDITION TO
 BENEFITS FOR A COURSE OF MANUAL LYMPH DRAINAGE WHOSE FREQUENCY AND DURA-
 TION  IS  DETERMINED  BY  THE  TREATING  PHYSICIAN OR THERAPIST BASED ON
 MEDICAL NECESSITY AND NOT BASED ON PHYSICAL THERAPY  AND  REHABILITATION
 STANDARDS,  BENEFITS FOR EQUIPMENT, SUPPLIES, DEVICES, COMPLEX DECONGES-
 TIVE THERAPY, AND OUT-PATIENT SELF-MANAGEMENT TRAINING AND EDUCATION FOR
 THE TREATMENT OF LYMPHEDEMA, IF PRESCRIBED BY A HEALTH CARE PROFESSIONAL
 LEGALLY AUTHORIZED TO PRESCRIBE OR PROVIDE SUCH ITEMS UNDER TITLE  EIGHT
 OF  THE  EDUCATION  LAW.    LYMPHEDEMA  THERAPY  ADMINISTERED UNDER THIS
 SECTION SHALL BE ADMINISTERED ONLY BY A THERAPIST CERTIFIED  TO  PERFORM
 LYMPHEDEMA  TREATMENT  BY  THE  LYMPHOLOGY  ASSOCIATION OF NORTH AMERICA
 (LANA) OR CERTIFIED IN  ACCORDANCE  WITH  STANDARDS  EQUIVALENT  TO  THE
 CERTIFICATION  STANDARDS  OF LANA.   SUCH EQUIPMENT, SUPPLIES OR DEVICES
 SHALL INCLUDE, BUT NOT BE LIMITED TO,  BANDAGES,  COMPRESSION  GARMENTS,
 PADS,  ORTHOTIC  SHOES  AND  DEVICES, WITH REPLACEMENTS WHEN REQUIRED TO
 MAINTAIN COMPRESSIVE FUNCTION OR TO ACCOMMODATE CHANGES IN THE PATIENT'S
 DIMENSIONS. COVERAGE SHALL BE PROVIDED  FOR  FOLLOW-UP  TREATMENTS  WHEN
 MEDICALLY REQUIRED OR TO PERIODICALLY VALIDATE HOME TECHNIQUES, TO MONI-
 TOR PROGRESS AGAINST THE WRITTEN TREATMENT PLAN AND TO MODIFY THE TREAT-
 MENT PLAN AS REQUIRED. NO INDIVIDUAL, OTHER THAN A LICENSED PHYSICIAN OR
 SURGEON  COMPETENT  TO EVALUATE THE SPECIFIC CLINICAL ISSUES INVOLVED IN
 THE CARE REQUESTED, MAY DENY REQUESTS FOR AUTHORIZATION OF  HEALTH  CARE
 SERVICES PURSUANT TO THIS SECTION.
   (1)  A  POLICY WHICH IS A MANAGED HEALTH CARE PRODUCT MAY REQUIRE SUCH
 HEALTH CARE PROFESSIONAL BE A MEMBER OF SUCH MANAGED HEALTH CARE  PLAN'S
 PROVIDER  NETWORK, PROVIDED THAT SUCH NETWORK INCLUDES SUFFICIENT HEALTH
 CARE PROFESSIONALS WHO ARE QUALIFIED BY SPECIFIC  EDUCATION,  EXPERIENCE
 AND  CREDENTIALS  TO  PROVIDE  THE  COVERED  BENEFITS  DESCRIBED IN THIS
 SUBSECTION.
   (2) NO INSURER, CORPORATION, OR HEALTH MAINTENANCE ORGANIZATION  SHALL
 IMPOSE  UPON  ANY  PERSON RECEIVING BENEFITS PURSUANT TO THIS SUBSECTION
 ANY COPAYMENT, FEE, POLICY YEAR OR CALENDAR YEAR, OR DURATIONAL  BENEFIT
 LIMITATION  OR  MAXIMUM  FOR  BENEFITS  OR  SERVICES THAT IS NOT EQUALLY
 IMPOSED UPON ALL INDIVIDUALS IN THE SAME BENEFIT CATEGORY.
   (3) THIS SUBSECTION SHALL NOT APPLY  TO  SHORT-TERM  TRAVEL,  ACCIDENT
 ONLY, LIMITED OR SPECIFIED DISEASE, OR INDIVIDUAL CONVERSION POLICIES OR

 S. 3321                             5
 
 CONTRACTS, NOR TO POLICIES OR CONTRACTS DESIGNED FOR ISSUANCE TO PERSONS
 ELIGIBLE  FOR  COVERAGE  UNDER  TITLE  XVIII OF THE SOCIAL SECURITY ACT,
 KNOWN AS MEDICARE, OR ANY OTHER SIMILAR COVERAGE UNDER STATE OR  FEDERAL
 GOVERNMENTAL PLANS.
   (4)  FOR  PURPOSES  OF THIS SUBSECTION, A "MANAGED CARE PRODUCT" SHALL
 MEAN A POLICY WHICH REQUIRES THAT MEDICAL OR OTHER HEALTH CARE  SERVICES
 COVERED  UNDER  THE  POLICY,  OTHER  THAN  EMERGENCY  CARE  SERVICES, BE
 PROVIDED BY, OR PURSUANT TO A REFERRAL FROM A PRIMARY CARE PROVIDER, AND
 THAT SERVICES PROVIDED PURSUANT TO SUCH A  REFERRAL  BE  RENDERED  BY  A
 HEALTH CARE PROVIDER PARTICIPATING IN THE INSURER'S MANAGED CARE PROVID-
 ER  NETWORK.  IN  ADDITION,  A  MANAGED CARE PRODUCT SHALL ALSO MEAN THE
 IN-NETWORK PORTION OF A CONTRACT WHICH REQUIRES THAT  MEDICAL  OR  OTHER
 HEALTH  CARE  SERVICES  COVERED UNDER THE CONTRACT, OTHER THAN EMERGENCY
 CARE SERVICES, BE PROVIDED BY, OR PURSUANT TO A REFERRAL FROM A  PRIMARY
 CARE PROVIDER, AND THAT SERVICES PROVIDED PURSUANT TO SUCH A REFERRAL BE
 RENDERED  BY  A  HEALTH  CARE  PROVIDER  PARTICIPATING  IN THE INSURER'S
 MANAGED CARE PROVIDER NETWORK, IN ORDER FOR THE INSURED TO  BE  ENTITLED
 TO THE MAXIMUM REIMBURSEMENT UNDER THE CONTRACT.
   (TT)  PATIENTS  UNDERGOING ANY SURGERY OR RADIOTHERAPY PROCEDURE SHALL
 BE PROVIDED INFORMATION ON THE RISK OF LYMPHEDEMA ASSOCIATED  WITH  THAT
 PROCEDURE,  AND  THE  POTENTIAL  POST-PROCEDURE  SYMPTOMS OF LYMPHEDEMA.
 INFORMED CONSENT AGREEMENTS FOR ALL SURGERIES  AND  RADIATION  THERAPIES
 SHALL  INCLUDE INFORMATION ON THE RISK OF LYMPHEDEMA ASSOCIATED WITH THE
 ALTERNATIVE PROCEDURES.
   § 7. This act shall take effect on the first of January next  succeed-
 ing  the date on which it shall have become a law and shall apply to all
 insurance policies,  contracts  and  plans  issued,  renewed,  modified,
 altered or amended on or after such effective date.