Assembly Bill A9228

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9228
 
                           I N  A S S E M B L Y
 
                             February 9, 2022
                                ___________
 
 Introduced by M. of A. HUNTER -- read once and referred to the Committee
   on Insurance
 
 AN  ACT  to  amend  the  insurance  law, the social services law and the
   public health law, in relation to requiring health insurance  policies
   to fully cover testing for ovarian cancer and requiring certain health
   care providers to offer annual testing for ovarian cancer

   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 OFFER FULL COVERAGE FOR ANNUAL TESTING TO PATIENTS
 THAT ARE AT HIGH-RISK OF DEVELOPING OVARIAN CANCER  INCLUDING,  BUT  NOT
 LIMITED  TO, FDA-APPROVED TESTING, TRANSVAGINAL ULTRASOUND, PELVIC EXAM,
 AND OTHER EXAMS REGARDLESS IF PRESENTING SIGNS AND SYMPTOMS.
   (B) SUCH ADDITIONAL COVERAGE SHALL NOT BE SUBJECT  TO  ANNUAL  DEDUCT-
 IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
   § 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 OFFER FULL  COVER-
 AGE FOR ANNUAL TESTING FOR INDIVIDUALS AT HIGH-RISK OF DEVELOPING OVARI-
 AN  CANCER INCLUDING, BUT NOT LIMITED TO, FDA-APPROVED TESTING, TRANSVA-
 GINAL ULTRASOUND, PELVIC EXAM  AND  OTHER EXAMS AVAILABLE  TO  THOSE  AT
 HIGH-RISK  OF  DEVELOPING  OVARIAN CANCER REGARDLESS IF PRESENTING SIGNS
 AND SYMPTOMS.
   (B) SUCH ADDITIONAL COVERAGE SHALL NOT BE SUBJECT  TO  ANNUAL  DEDUCT-
 IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
   §  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 OFFER FULL COVERAGE FOR  ANNUAL
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD13344-03-2
 A. 9228                             2
 
 TESTING  FOR  INDIVIDUALS  AT  HIGH-RISK  OF  DEVELOPING  OVARIAN CANCER
 INCLUDING, BUT NOT LIMITED TO, FDA-APPROVED TESTING, TRANSVAGINAL ULTRA-
 SOUND, PELVIC EXAM AND OTHER  EXAMS  FOR  INDIVIDUALS  AT  HIGH-RISK  OF
 DEVELOPING OVARIAN CANCER REGARDLESS IF PRESENTING SIGNS OR SYMPTOMS.
   (2)  SUCH  ADDITIONAL  COVERAGE SHALL NOT BE SUBJECT TO ANNUAL DEDUCT-
 IBLES AND COINSURANCE BUT SHALL BE BORNE SOLELY BY THE INSURER.
   § 4. Subdivision 2 of section 365-a of  the  social  services  law  is
 amended by adding a new paragraph (iii) to read as follows:
   (III)  ANNUAL  OVARIAN  CANCER  TESTING INCLUDING, BUT NOT LIMITED TO,
 FDA-APPROVED TESTING, PELVIC EXAM, TRANSVAGINAL ULTRASOUND  AND    OTHER
 EXAMS  AVAILABLE  TO THOSE AT RISK OR HIGH-RISK FOR CANCER REGARDLESS IF
 PRESENTING SIGNS AND SYMPTOMS.
   § 5. The public health law is amended by adding a new  section  2405-a
 to read as follows:
   § 2405-A. REQUIRED OFFERING OF OVARIAN CANCER TESTING.  1. HEALTH CARE
 PROVIDERS  SUCH AS A PHYSICIAN, PHYSICIAN ASSISTANT, NURSE PRACTITIONER,
 OR MIDWIFE PROVIDING PRIMARY CARE SHALL ASK SPECIFIC QUESTIONS TO DETER-
 MINE IF THERE ARE ANY  SIGNS  OR  SYMPTOMS  THAT  MAY  INDICATE  OVARIAN
 CANCER. ONCE SIGNS AND SYMPTOMS OF OVARIAN CANCER HAVE BEEN DETECTED, OR
 A  PROVIDER IS SUSPICIOUS THE PATIENT HAS OVARIAN CANCER, OVARIAN CANCER
 "TESTING" MAY THEN BE PERFORMED, WHICH COULD ENCOMPASS  A  PELVIC  EXAM,
 FDA-APPROVED  TESTING,  TRANSVAGINAL  ULTRASOUND,  AND  OTHER  EXAMS FOR
 OVARIAN CANCER. ADDITIONALLY, PROVIDERS SHALL AVAIL PATIENTS WITH OVARI-
 AN CANCER EDUCATION, INCLUDING, BUT NOT LIMITED TO, INFORMATION  ON  THE
 SIGNS  AND  SYMPTOMS  OF OVARIAN CANCER AND PROVIDING THE PATIENT WITH A
 COPY OF THE INFORMATIONAL PAMPHLET DEVELOPED AND SUPPLIED BY THE DEPART-
 MENT, UNLESS  THE  HEALTH  CARE  PRACTITIONER  PROVIDING  SUCH  SERVICES
 REASONABLY BELIEVES THAT: (A) THE INDIVIDUAL IS BEING TREATED FOR A LIFE
 THREATENING  EMERGENCY;  OR (B) THE INDIVIDUAL LACKS CAPACITY TO CONSENT
 TO OVARIAN CANCER TESTING.
   2. AS USED IN THIS SECTION, "PRIMARY CARE" MEANS THE MEDICAL FIELDS OF
 FAMILY MEDICINE, GENERAL PEDIATRICS, PRIMARY  CARE,  INTERNAL  MEDICINE,
 PRIMARY  CARE  OBSTETRICS, OR PRIMARY CARE GYNECOLOGY, WITHOUT REGARD TO
 BOARD CERTIFICATION.
   3. THE OFFERING OF OVARIAN CANCER TESTING UNDER THIS SECTION SHALL  BE
 CULTURALLY  AND  LINGUISTICALLY APPROPRIATE IN ACCORDANCE WITH RULES AND
 REGULATIONS PROMULGATED BY THE COMMISSIONER.
   4. THE DEPARTMENT SHALL DEVELOP  INFORMATIONAL  PAMPHLETS  ON  OVARIAN
 CANCER AND SUPPLY SUCH PAMPHLETS TO HEALTH SERVICE PROVIDERS.
   5.  THIS  SECTION SHALL NOT AFFECT THE SCOPE OF PRACTICE OF ANY HEALTH
 CARE PRACTITIONER OR DIMINISH ANY AUTHORITY  OR  LEGAL  OR  PROFESSIONAL
 OBLIGATION OF ANY HEALTH CARE PRACTITIONER TO OFFER OVARIAN CANCER TEST-
 ING  OR  TO  PROVIDE  SERVICES OR CARE FOR THE SUBJECT OF OVARIAN CANCER
 TESTING.
   § 6. 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
 policies issued, reissued, renewed, modified or amended on or after such
 date.