The New York State Senate

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2198
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 23, 2023
                                ___________
 
 Introduced by M. of A. DINOWITZ -- read once and referred to the Commit-
   tee on Insurance
 
 AN  ACT  to  amend  the  insurance law and a chapter of the laws of 2022
   relating to providing insurance coverage for colorectal  cancer  early
   detection,  as  proposed  in legislative bills numbers S. 906-B and A.
   2085-A, in relation to coverage for preventive screenings  and  notice
   requirements;  and  to  repeal certain provisions of the insurance law
   and of such chapter relating thereto
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Paragraph  11-b  of subsection (i) of section 3216 of the
 insurance law, as added by a chapter of the laws of  2022  amending  the
 insurance  law  relating to providing insurance  coverage for colorectal
 cancer early detection, as proposed in legislative bills numbers S.906-B
 and A. 2085-A, is REPEALED.
   § 2. Paragraph 11-b of subsection (l) of section 3221 of the insurance
 law,  as  added  by a chapter of the laws of 2022 amending the insurance
 law relating to providing insurance    coverage  for  colorectal  cancer
 early detection, as proposed in legislative bills numbers S.906-B and A.
 2085-A,  is amended to read as follows:
   (11-b)  (A)  Every LARGE GROUP 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 LARGE GROUP  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]  ACTING WITHIN THE PROVIDER'S SCOPE OF
 PRACTICE PURSUANT TO title eight of  the  education  law,  coverage  for
 colorectal  cancer  [screening] PREVENTIVE SCREENINGS IN ACCORDANCE WITH
 THE AMERICAN CANCER SOCIETY GUIDELINES FOR COLORECTAL  CANCER  SCREENING
 OF  AVERAGE  RISK  INDIVIDUALS.  The coverage required by this paragraph
 shall ALSO include [preventive colorectal cancer screening] coverage for
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04015-01-3

 A. 2198                             2
 
 all ADDITIONAL  colorectal  cancer  examinations  and  laboratory  tests
 RECOMMENDED  in  accordance  with THE American Cancer Society Guidelines
 for colorectal cancer screening of average risk  individuals,  including
 an initial colonoscopy or other medical test or procedure for colorectal
 cancer  screening and a follow-up colonoscopy performed as a result of a
 positive result on a non-colonoscopy preventive screening test. A  LARGE
 GROUP POLICY SHALL COVER COLORECTAL CANCER SCREENINGS, EXAMINATIONS, AND
 LABORATORY TESTS DESCRIBED IN THIS PARAGRAPH UPON ANY POLICY ISSUANCE OR
 RENEWAL THAT OCCURS SIX MONTHS AFTER THE DATE THE GUIDELINE DESCRIBED IN
 THIS PARAGRAPH IS ISSUED.
   (B)  An  [individual]  INSURED  shall  not be subject to a deductible,
 coinsurance,  or  any  other  cost-sharing  requirements  for   services
 consistent with subparagraph (A) of this paragraph received from partic-
 ipating providers.
   §  3.  Section  4303  of  the insurance law is amended by adding a new
 subsection (uu) to read as follows:
   (UU) (1) EVERY LARGE GROUP CONTRACT 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  LARGE GROUP
 CONTRACT WHICH PROVIDES  MAJOR  MEDICAL  OR  SIMILAR  COMPREHENSIVE-TYPE
 COVERAGE  SHALL PROVIDE, UPON THE PRESCRIPTION OF A HEALTH CARE PROVIDER
 ACTING WITHIN THE PROVIDER'S SCOPE OF PRACTICE PURSUANT TO  TITLE  EIGHT
 OF  THE EDUCATION LAW, COVERAGE FOR COLORECTAL CANCER PREVENTIVE SCREEN-
 INGS IN ACCORDANCE WITH THE AMERICAN CANCER SOCIETY GUIDELINES FOR COLO-
 RECTAL CANCER  SCREENING  OF  AVERAGE  RISK  INDIVIDUALS.  THE  COVERAGE
 REQUIRED  BY  THIS  SUBSECTION SHALL ALSO INCLUDE COVERAGE FOR ALL ADDI-
 TIONAL COLORECTAL CANCER EXAMINATIONS AND LABORATORY  TESTS  RECOMMENDED
 IN ACCORDANCE WITH THE AMERICAN CANCER SOCIETY GUIDELINES FOR COLORECTAL
 CANCER SCREENING OF AVERAGE RISK INDIVIDUALS, INCLUDING AN INITIAL COLO-
 NOSCOPY OR OTHER MEDICAL TEST OR PROCEDURE FOR COLORECTAL CANCER SCREEN-
 ING  AND  A  FOLLOW-UP  COLONOSCOPY  PERFORMED AS A RESULT OF A POSITIVE
 RESULT ON A NON-COLONOSCOPY PREVENTIVE SCREENING  TEST.  A  LARGE  GROUP
 CONTRACT  SHALL  COVER  COLORECTAL  CANCER SCREENINGS, EXAMINATIONS, AND
 LABORATORY TESTS DESCRIBED IN THIS SUBSECTION UPON ANY CONTRACT ISSUANCE
 OR RENEWAL THAT OCCURS SIX MONTHS AFTER THE DATE THE GUIDELINE DESCRIBED
 IN THIS SUBSECTION IS ISSUED.
   (2) AN ENROLLEE SHALL NOT BE SUBJECT TO A DEDUCTIBLE, COINSURANCE,  OR
 ANY  OTHER  COST-SHARING REQUIREMENTS FOR SERVICES CONSISTENT WITH PARA-
 GRAPH ONE OF THIS SUBSECTION RECEIVED FROM PARTICIPATING PROVIDERS.
   § 4. Section 3 of a chapter of the laws of 2022 relating to  providing
 insurance coverage for colorectal cancer early detection, as proposed in
 legislative bills numbers S.906-B and A. 2085-A, is REPEALED.
   §  5. The insurance law is amended by adding a new section 339 to read
 as follows:
   § 339. COLORECTAL CANCER SCREENING  NOTIFICATION.  THE  SUPERINTENDENT
 SHALL  REQUIRE AN INSURER AUTHORIZED TO WRITE ACCIDENT AND HEALTH INSUR-
 ANCE IN THIS STATE, A CORPORATION ORGANIZED PURSUANT TO  ARTICLE  FORTY-
 THREE  OF  THIS CHAPTER, AND A HEALTH MAINTENANCE ORGANIZATION CERTIFIED
 PURSUANT TO ARTICLE FORTY-FOUR  OF  THE  PUBLIC  HEALTH  LAW  TO  NOTIFY
 INSUREDS AND ENROLLEES AT LEAST ANNUALLY OF COLORECTAL CANCER SCREENINGS
 COVERED  BY  SUCH  INSUREDS'  OR  ENROLLEES'  HEALTH INSURANCE POLICY OR
 CONTRACT, AND OF THE MOST RECENTLY PUBLISHED GUIDELINES OF THE  AMERICAN
 CANCER SOCIETY FOR COLORECTAL CANCER SCREENINGS THAT ARE COVERED BY SUCH
 INSUREDS'  OR ENROLLEES' HEALTH INSURANCE POLICY OR CONTRACT. THE NOTICE
 SHALL BE DELIVERED BY UNITED STATES POSTAL MAIL UNLESS  THE  INSURED  OR
 A. 2198                             3
 
 ENROLLEE CONSENTS TO ANOTHER METHOD OF NOTIFICATION, INCLUDING ELECTRON-
 IC NOTIFICATION.
   §  6. Section 4 of a chapter of the laws of 2022 relating to providing
 insurance coverage for colorectal cancer early detection, as proposed in
 legislative bills numbers S.906-B and A. 2085-A, is amended to  read  as
 follows:
   §  4.  This  act  shall take effect immediately and shall apply to any
 policy issued, [delivered,]  renewed,  [and/or]  modified,  ALTERED,  OR
 AMENDED on or after the effective date of this act.
   §  7.  This  act shall take effect immediately; provided that sections
 one, two, three, four and five of this act shall take effect on the same
 date and in the same manner as of a chapter of the laws of 2022 relating
 to providing insurance coverage for colorectal cancer  early  detection,
 as  proposed  in  legislative bills numbers S.906-B and A. 2085-A, takes
 effect.