S T A T E O F N E W Y O R K
________________________________________________________________________
7944--A
2025-2026 Regular Sessions
I N A S S E M B L Y
April 16, 2025
___________
Introduced by M. of A. SAYEGH, BUTTENSCHON, P. CARROLL, LEVENBERG,
MAGNARELLI, BORES, BRABENEC, McDONOUGH, ANGELINO -- read once and
referred to the Committee on Insurance -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee
AN ACT to amend the insurance law and the public health law, in relation
to ensuring continuity of care for cancer patients during insurance
contract negotiations
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. This act shall be known and may be cited as the "Continuity
of Cancer Care Act" or the "COCCA".
§ 2. Section 3216 of the insurance law is amended by adding a new
subsection (n) to read as follows:
(N) (1) FOR THE PURPOSE OF THIS SUBSECTION:
(A) "COURSE OF TREATMENT" SHALL MEAN THAT THE TREATMENT PROTOCOL AIMED
AT COMBATING THE INSURED'S CANCER HAS BEEN ADMINISTERED AND THE INSURED
IS CLINICALLY STABLE. ADDITIONALLY, FOLLOW-UP APPOINTMENTS/CARE FOR UP
TO NINETY DAYS AFTER THE INSURED IS FOUND TO BE CLINICALLY STABLE SHALL
ALSO BE CONSIDERED PART OF THE INSURED'S COURSE OF TREATMENT.
(B) "CLINICAL STABILITY" SHALL MEAN NINETY DAYS HAVE PASSED SINCE THE
TREATMENT HAS BEEN FULLY ADMINISTERED AND: (I) THE INSURED SHOWS THE
INTENDED RESULT FROM THEIR TREATMENT PROTOCOL WITHOUT COMPLICATIONS THAT
WOULD REQUIRE ONGOING MANAGEMENT BY THE PROVIDER'S PHYSICIANS; OR (II)
THE INSURED IS RECEIVING MAINTENANCE TREATMENT TO CONTROL THE CANCER
FROM REOCCURRING.
(2) AN INSURER SHALL, WHERE AN INSURED IS RECEIVING TREATMENT FOR
CANCER AT A HOSPITAL, DOCTOR'S OFFICE OR ANY OTHER PROVIDER THAT
PROVIDES ONCOLOGY TREATMENT WHICH SUCH INSURER WAS COVERING IN WHOLE OR
IN PART AND SUCH INSURER AND SUCH PROVIDER CANNOT COME TO AN AGREEMENT
DURING CONTRACT NEGOTIATIONS, CONTINUE TO COVER SUCH TREATMENTS, AT THE
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10785-02-5
A. 7944--A 2
RATE PAYABLE UNDER THE PRIOR CONTRACT, FOR SUCH INSURED UNTIL THE
CONCLUSION OF SUCH INSURED'S ENTIRE COURSE OF TREATMENT AND THE INDIVID-
UAL IS FOUND TO BE CLINICALLY STABLE, PROVIDED THAT THE RATE PAYABLE
UNDER THE PRIOR CONTRACT SHALL BE ADJUSTED BY THE APPLICABLE MEDICARE
ECONOMIC INDEX MINUS ONE PERCENTAGE POINT APPLIED TO PAYMENT RATES AT
THE START OF THE NEXT CALENDAR YEAR, AND FOR EACH SUCCEEDING CALENDAR
YEAR, FOR INDIVIDUALS THAT ARE CONTINUING TO RECEIVE TREATMENT PURSUANT
TO THIS PROVISION.
§ 3. Section 3221 of the insurance law is amended by adding a new
subsection (v) to read as follows:
(V) (1) FOR THE PURPOSE OF THIS SUBSECTION:
(A) "COURSE OF TREATMENT" SHALL MEAN THAT THE TREATMENT PROTOCOL AIMED
AT COMBATING THE INSURED'S CANCER HAS BEEN ADMINISTERED AND THE INSURED
IS CLINICALLY STABLE. ADDITIONALLY, FOLLOW-UP APPOINTMENTS/CARE FOR UP
TO NINETY DAYS AFTER THE INSURED IS FOUND TO BE CLINICALLY STABLE SHALL
ALSO BE CONSIDERED PART OF THE INSURED'S COURSE OF TREATMENT.
(B) "CLINICAL STABILITY" SHALL MEAN NINETY DAYS HAVE PASSED SINCE THE
TREATMENT HAS BEEN FULLY ADMINISTERED AND: (I) THE INSURED SHOWS THE
INTENDED RESULT FROM THEIR TREATMENT PROTOCOL WITHOUT COMPLICATIONS THAT
WOULD REQUIRE ONGOING MANAGEMENT BY THE PROVIDER'S PHYSICIANS; OR (II)
THE INSURED IS RECEIVING MAINTENANCE TREATMENT TO CONTROL THE CANCER
FROM REOCCURRING.
(2) AN INSURER SHALL, WHERE AN INSURED IS RECEIVING TREATMENT FOR
CANCER AT A HOSPITAL, DOCTOR'S OFFICE OR ANY OTHER PROVIDER THAT
PROVIDES ONCOLOGY TREATMENT WHICH SUCH INSURER WAS COVERING IN WHOLE OR
IN PART AND SUCH INSURER AND SUCH PROVIDER CANNOT COME TO AN AGREEMENT
DURING CONTRACT NEGOTIATIONS, CONTINUE TO COVER SUCH TREATMENTS, AT THE
RATE PAYABLE UNDER THE PRIOR CONTRACT, FOR SUCH INSURED UNTIL THE
CONCLUSION OF SUCH INSURED'S ENTIRE COURSE OF TREATMENT AND THE INDIVID-
UAL IS FOUND TO BE CLINICALLY STABLE, PROVIDED THAT THE RATE PAYABLE
UNDER THE PRIOR CONTRACT SHALL BE ADJUSTED BY THE APPLICABLE MEDICARE
ECONOMIC INDEX MINUS ONE PERCENTAGE POINT APPLIED TO PAYMENT RATES AT
THE START OF THE NEXT CALENDAR YEAR, AND FOR EACH SUCCEEDING CALENDAR
YEAR, FOR INDIVIDUALS THAT ARE CONTINUING TO RECEIVE TREATMENT PURSUANT
TO THIS PROVISION.
§ 4. Section 4303 of the insurance law is amended by adding a new
subsection (i) to read as follows:
(I) (1) FOR THE PURPOSE OF THIS SUBSECTION:
(A) "COURSE OF TREATMENT" SHALL MEAN THAT THE TREATMENT PROTOCOL AIMED
AT COMBATING THE INSURED'S CANCER HAS BEEN ADMINISTERED AND THE INSURED
IS CLINICALLY STABLE. ADDITIONALLY, FOLLOW-UP APPOINTMENTS/CARE FOR UP
TO NINETY DAYS AFTER THE INSURED IS FOUND TO BE CLINICALLY STABLE SHALL
ALSO BE CONSIDERED PART OF THE INSURED'S COURSE OF TREATMENT.
(B) "CLINICAL STABILITY" SHALL MEAN NINETY DAYS HAVE PASSED SINCE THE
TREATMENT HAS BEEN FULLY ADMINISTERED AND: (I) THE INSURED SHOWS THE
INTENDED RESULT FROM THEIR TREATMENT PROTOCOL WITHOUT COMPLICATIONS THAT
WOULD REQUIRE ONGOING MANAGEMENT BY THE PROVIDER'S PHYSICIANS; OR (II)
THE INSURED IS RECEIVING MAINTENANCE TREATMENT TO CONTROL THE CANCER
FROM REOCCURRING.
(2) AN INSURER SHALL, WHERE AN INSURED IS RECEIVING TREATMENT FOR
CANCER AT A HOSPITAL, DOCTOR'S OFFICE OR ANY OTHER PROVIDER THAT
PROVIDES ONCOLOGY TREATMENT WHICH SUCH INSURER WAS COVERING IN WHOLE OR
IN PART AND SUCH INSURER AND SUCH PROVIDER CANNOT COME TO AN AGREEMENT
DURING CONTRACT NEGOTIATIONS, CONTINUE TO COVER SUCH TREATMENTS, AT THE
RATE PAYABLE UNDER THE PREVIOUS CONTRACT, FOR SUCH INSURED UNTIL THE
CONCLUSION OF SUCH INSURED'S ENTIRE COURSE OF TREATMENT AND THE INSURED
A. 7944--A 3
IS FOUND TO BE CLINICALLY STABLE, PROVIDED THAT THE RATE PAYABLE UNDER
THE PRIOR CONTRACT SHALL BE ADJUSTED BY THE APPLICABLE MEDICARE ECONOMIC
INDEX MINUS ONE PERCENTAGE POINT APPLIED TO PAYMENT RATES AT THE START
OF THE NEXT CALENDAR YEAR, AND FOR EACH SUCCEEDING CALENDAR YEAR, FOR
INDIVIDUALS THAT ARE CONTINUING TO RECEIVE TREATMENT PURSUANT TO THIS
PROVISION.
§ 5. The public health law is amended by adding a new section 4406-j
to read as follows:
§ 4406-J. CONTINUITY OF CANCER CARE. 1. FOR THE PURPOSE OF THIS
SECTION:
(A) "COURSE OF TREATMENT" SHALL MEAN THAT THE TREATMENT PROTOCOL AIMED
AT COMBATING THE INSURED'S CANCER HAS BEEN ADMINISTERED AND THE INSURED
IS CLINICALLY STABLE. ADDITIONALLY, FOLLOW-UP APPOINTMENTS/CARE FOR UP
TO NINETY DAYS AFTER THE INSURED IS FOUND TO BE CLINICALLY STABLE SHALL
ALSO BE CONSIDERED PART OF THE INSURED'S COURSE OF TREATMENT.
(B) "CLINICAL STABILITY" SHALL MEAN NINETY DAYS HAVE PASSED SINCE THE
TREATMENT HAS BEEN FULLY ADMINISTERED AND: (I) THE INSURED SHOWS THE
INTENDED RESULT FROM THEIR TREATMENT PROTOCOL WITHOUT COMPLICATIONS THAT
WOULD REQUIRE ONGOING MANAGEMENT BY THE PROVIDER'S PHYSICIANS; OR (II)
THE INSURED IS RECEIVING MAINTENANCE TREATMENT TO CONTROL THE CANCER
FROM REOCCURRING.
2. AN ORGANIZATION SHALL, WHERE AN INSURED IS RECEIVING TREATMENT
FOR CANCER AT A HOSPITAL, DOCTOR'S OFFICE OR ANY OTHER PROVIDER THAT
PROVIDES ONCOLOGY TREATMENT WHICH SUCH ORGANIZATION WAS COVERING IN
WHOLE OR IN PART AND SUCH ORGANIZATION AND SUCH PROVIDER CANNOT
COME TO AN AGREEMENT DURING CONTRACT NEGOTIATIONS, CONTINUE TO COVER
SUCH TREATMENTS, AT THE RATE PAYABLE UNDER THE PRIOR CONTRACT, FOR SUCH
INSURED UNTIL THE CONCLUSION OF SUCH INSURED'S ENTIRE COURSE OF TREAT-
MENT AND THE INDIVIDUAL IS FOUND TO BE CLINICALLY STABLE, PROVIDED THAT
THE RATE PAYABLE UNDER THE PRIOR CONTRACT SHALL BE ADJUSTED BY THE
APPLICABLE MEDICARE ECONOMIC INDEX MINUS ONE PERCENTAGE POINT APPLIED TO
PAYMENT RATES AT THE START OF THE NEXT CALENDAR YEAR, AND FOR EACH
SUCCEEDING CALENDAR YEAR, FOR INDIVIDUALS THAT ARE CONTINUING TO RECEIVE
TREATMENT PURSUANT TO THIS PROVISION.
§ 6. The public health law is amended by adding a new section 2404-e
to read as follows:
§ 2404-E. CANCER; DUTY TO CONTINUE TREATMENT. 1. FOR THE PURPOSE OF
THIS SECTION:
(A) "COURSE OF TREATMENT" SHALL MEAN THAT THE TREATMENT PROTOCOL AIMED
AT COMBATING THE INSURED'S CANCER HAS BEEN ADMINISTERED AND THE INSURED
IS CLINICALLY STABLE. ADDITIONALLY, FOLLOW-UP APPOINTMENTS/CARE FOR UP
TO NINETY DAYS AFTER THE INSURED IS FOUND TO BE CLINICALLY STABLE SHALL
ALSO BE CONSIDERED PART OF THE INSURED'S COURSE OF TREATMENT.
(B) "CLINICAL STABILITY" SHALL MEAN NINETY DAYS HAVE PASSED SINCE THE
TREATMENT HAS BEEN FULLY ADMINISTERED AND: (I) THE INSURED SHOWS THE
INTENDED RESULT FROM THEIR TREATMENT PROTOCOL WITHOUT COMPLICATIONS THAT
WOULD REQUIRE ONGOING MANAGEMENT BY THE PROVIDER'S PHYSICIANS; OR (II)
THE INSURED IS RECEIVING MAINTENANCE TREATMENT TO CONTROL THE CANCER
FROM REOCCURRING.
2. WHERE A PERSON IS RECEIVING TREATMENT FOR CANCER AT A HOSPITAL,
DOCTOR'S OFFICE OR ANY OTHER PROVIDER THAT PROVIDES ONCOLOGY TREATMENT
WHICH IS COVERED BY SUCH PERSON'S INSURANCE COMPANY AND SUCH PROVIDER
AND SUCH PERSON'S INSURANCE COMPANY CANNOT COME TO AN AGREEMENT DURING
CONTRACT NEGOTIATIONS, SUCH PERSON SHALL REMAIN UNDER CONTINUOUS CARE OF
SUCH PROVIDER AND SUCH PERSON'S INSURANCE SHALL CONTINUE TO PROVIDE SUCH
COVERAGE FOR SUCH TREATMENTS, AT THE RATE PAYABLE UNDER THE PRIOR
A. 7944--A 4
CONTRACT, UNTIL THE CONCLUSION OF SUCH PERSON'S ENTIRE COURSE OF TREAT-
MENT AND THE INSURED IS FOUND TO BE CLINICALLY STABLE, PROVIDED THAT THE
RATE PAYABLE UNDER THE PRIOR CONTRACT SHALL BE ADJUSTED BY THE APPLICA-
BLE MEDICARE ECONOMIC INDEX MINUS ONE PERCENTAGE POINT APPLIED TO
PAYMENT RATES AT THE START OF THE NEXT CALENDAR YEAR, AND FOR EACH
SUCCEEDING CALENDAR YEAR, FOR INDIVIDUALS THAT ARE CONTINUING TO RECEIVE
TREATMENT PURSUANT TO THIS PROVISION.
§ 7. This act shall take effect immediately.