assembly Bill A9149

2021-2022 Legislative Session

Requires health insurance policies and medicaid to cover biomarker testing for certain purposes

download bill text pdf

Sponsored By

Current Bill Status - In Assembly Committee


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor

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Actions

view actions (1)
Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 31, 2022 referred to insurance

Co-Sponsors

A9149 (ACTIVE) - Details

See Senate Version of this Bill:
S8147
Current Committee:
Assembly Insurance
Law Section:
Insurance Law
Laws Affected:
Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L

A9149 (ACTIVE) - Summary

Requires health insurance policies and medicaid to cover biomarker testing for diagnosis, treatment, appropriate management, or ongoing monitoring of a covered person's disease or condition when the test is supported by medical and scientific evidence.

A9149 (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9149
 
                           I N  A S S E M B L Y
 
                             January 31, 2022
                                ___________
 
 Introduced by M. of A. HUNTER -- read once and referred to the Committee
   on Insurance
 
 AN  ACT  to  amend  the  insurance  law  and the social services law, in
   relation to requiring health insurance policies and medicaid to  cover
   biomarker testing for certain purposes
 
   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  WHICH  PROVIDES MEDICAL, MAJOR MEDICAL, OR
 SIMILAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR BIOMARKER
 TESTING FOR THE PURPOSES OF DIAGNOSIS,  TREATMENT,  APPROPRIATE  MANAGE-
 MENT,  OR  ONGOING MONITORING OF A COVERED PERSON'S DISEASE OR CONDITION
 WHEN THE TEST IS SUPPORTED BY MEDICAL AND SCIENTIFIC  EVIDENCE,  INCLUD-
 ING, BUT NOT LIMITED TO:
   (I) LABELED INDICATIONS FOR A TEST APPROVED OR CLEARED BY THE FOOD AND
 DRUG  ADMINISTRATION  OF THE UNITED STATES GOVERNMENT OR INDICATED TESTS
 FOR A FOOD AND DRUG ADMINISTRATION APPROVED DRUG;
   (II) CENTERS FOR MEDICARE  AND  MEDICAID  SERVICES  NATIONAL  COVERAGE
 DETERMINATIONS  AND  MEDICARE  ADMINISTRATIVE  CONTRACTOR LOCAL COVERAGE
 DETERMINATIONS; OR
   (III) NATIONALLY RECOGNIZED CLINICAL PRACTICE GUIDELINES AND CONSENSUS
 STATEMENTS.
   (B) SUCH COVERAGE SHALL BE PROVIDED  IN  A  MANNER  THAT  SHALL  LIMIT
 DISRUPTIONS  IN CARE INCLUDING THE NEED FOR MULTIPLE BIOPSIES OR BIOSPE-
 CIMEN SAMPLES.
   (C) THE COVERED PERSON AND PRESCRIBING PRACTITIONER SHALL HAVE  ACCESS
 TO  A  CLEAR,  READILY  ACCESSIBLE, AND CONVENIENT PROCESS TO REQUEST AN
 EXCEPTION TO A COVERAGE POLICY PROVIDED PURSUANT TO  THE  PROVISIONS  OF
 THIS  PARAGRAPH.  SUCH  PROCESS  SHALL BE MADE READILY ACCESSIBLE ON THE
 WEBSITE OF THE INSURER.
   (D) AS USED IN THIS PARAGRAPH, THE  FOLLOWING  TERMS  SHALL  HAVE  THE
 FOLLOWING MEANINGS:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD13311-02-2