S T A T E O F N E W Y O R K
________________________________________________________________________
3791
2021-2022 Regular Sessions
I N A S S E M B L Y
January 28, 2021
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Introduced by M. of A. CYMBROWITZ, NOLAN, GUNTHER, SIMON, BARRON, JACOB-
SON, MAGNARELLI, GOTTFRIED, SEAWRIGHT, RICHARDSON, ABBATE, ENGLE-
BRIGHT, GALEF -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring health
insurance providers to cover the costs of colorectal cancer screenings
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, COVERAGE FOR COLORECTAL CANCER
SCREENING FOR PERSONS FORTY-FIVE YEARS OF AGE OR OLDER. SUCH COVERAGE
SHALL INCLUDE AN ANNUAL SCREENING USING THE STOOL-BASED FECAL IMMUNO-
CHEMICAL TEST OR THE GUAIAC-BASED FECAL OCCULT BLOOD TEST. IF THE
RESULTS OF SUCH TEST ARE POSITIVE FOR SIGNS OF CANCER, COVERAGE SHALL
ALSO BE PROVIDED FOR A FOLLOW-UP VISUAL EXAMINATION.
(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
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, COVERAGE FOR COLORECTAL CANCER
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD07633-01-1
A. 3791 2
SCREENING FOR PERSONS FORTY-FIVE YEARS OF AGE OR OLDER. SUCH COVERAGE
SHALL INCLUDE AN ANNUAL SCREENING USING THE STOOL-BASED FECAL IMMUNO-
CHEMICAL TEST OR THE GUAIAC-BASED FECAL OCCULT BLOOD TEST. IF THE
RESULTS OF SUCH TEST ARE POSITIVE FOR SIGNS OF CANCER, COVERAGE SHALL
ALSO BE PROVIDED FOR A FOLLOW-UP VISUAL EXAMINATION.
(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, COVERAGE FOR COLORECTAL CANCER
SCREENING FOR PERSONS FORTY-FIVE YEARS OF AGE OR OLDER. SUCH COVERAGE
SHALL INCLUDE AN ANNUAL SCREENING USING THE STOOL-BASED FECAL IMMUNO-
CHEMICAL TEST OR THE GUAIAC-BASED FECAL OCCULT BLOOD TEST. IF THE
RESULTS OF SUCH TEST ARE POSITIVE FOR SIGNS OF CANCER, COVERAGE SHALL
ALSO BE PROVIDED FOR A FOLLOW-UP VISUAL EXAMINATION.
(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 ninetieth day after it shall
have become a law and shall apply to all policies issued, renewed, modi-
fied or altered on or after such date.