Assembly Actions -
Senate Actions - UPPERCASE
|Jan 31, 2022
referred to insurance
Assembly Bill A9149
2021-2022 Legislative Session
Archive: Last Bill Status - In Assembly Committee
- In Committee Assembly
- On Floor Calendar Assembly
- Passed Assembly
- Delivered to Governor
- Signed By Governor
2021-A9149 (ACTIVE) - Details
2021-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
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