Requires coverage for cervical cytology screening for insureds by certain corporations and insurance policies

1 Co-sponsor

• Tony Avella

BILL NUMBER:S1312

Title of bill

An act to amend the insurance law, in relation to coverage for cervical cytology screening for insureds by certain corporations and insurance policies

Purpose or general idea of bill

To update the 1993 law that provides coverage for cervical cancer screening in order to reflect current clinical guidelines related to testing frequency

Summary of specific provisions

Section one provides that certain insurance policies provide reimbursement coverage for cervical cytology screening for cervical cancer and its precursor states on a schedule that is consistent with the guidelines established by the American College of Obstetricians and the Gynecologists (AGOG) and the American Cancer Society (ACS). Women with certain risk factors, who may need more frequent screening in the reasonable medical judgment of their attending health care professional, shall be screened at a frequency that is determined by such health care professional.

Section two provides that every group or blanket policy which provides surgical or medical coverage shall provide coverage for cervical cytology screening for cervical cancer and its precursor states on a schedule that is consistent with the guidelines established by the American college of Obstetricians and the Gynecologists (ACOG) and the American Cancer Society (ACS). Women with certain risk factors, who may need more frequent screening in the reasonable medical judgment of their attending health care professional, shall be screened at a frequency that is determined by such health care professional.

Section three provides that a medical expense indemnity corporation, a hospital service corporation or a health service corporation which provides coverage for hospital, surgical, or medical care shall provide coverage for cervical cytology screening for cervical cancer and its precursor states on a schedule that is consistent with the guidelines established by the American College of Obstetricians and the Gynecologists (ACOG) and the American Cancer Society (ACS). Women with certain risk factors, who may need more frequent screening in the reasonable medical judgment of their attending health care professional, shall be screened at a frequency that is determined by such health care professional.

Section four provides the effective date.

Justification

The current law applying to insurance coverage for cervical cytology screening no longer reflects the most current evidence-based clinical guidelines for routine cervical cytology screening methods and frequency. In order to prevent cervical cancer and detect a human papiloma viral (HPV) infection, this legislation updates the late by

providing that physicians utilize updated testing methods at a frequency that is in accordance with the most recent evidence-based clinical guidelines. By adhering to such guidelines, it will also ensure that physicians are adequately reimbursed.

Prior legislative history

2009-10: A.6458 - Referred to Insurance 2011-12: S.6603 - Referred to Insurance

Fiscal implication

None to the state. Insurance companies already provide reimbursement for cervical cytology screening under current law. This legislation would help streamline testing frequency and prohibit outdated and unnecessary testing methods, thereby decreasing potential costs.

Effective date

This act shall take effect on the first of January next succeeding the date on which it shall become law and shall apply to all policies issued, renewed, modified or altered on or after such date.