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.