What's happening
This bill requires New York health insurance policies to fully cover comprehensive genetic testing for certain cancers when recommended, with no patient cost-sharing.
Why it matters
Significantly expands access to advanced cancer screening. by requiring insurance to cover comprehensive genetic testing for breast, ovarian, prostate, colon, and lung cancers, but only when recommended by a board-certified geneticist or genetic counselor—helping to ensure medically appropriate use.
Eliminates out-of-pocket costs. for patients (such as deductibles and coinsurance) for these genetic tests, reducing financial barriers to early cancer detection and personalized risk assessment.
Targets populations at higher risk. for these cancers, potentially leading to earlier interventions, tailored surveillance, and more effective preventive strategies based on individual genetic risk.
May influence insurance premiums and plan structures. since all costs must be absorbed by insurers, raising questions about the long-term financial impact on insurance pools and broader healthcare system spending.
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Who cares
Headline styles
Require Cancer Genetic Screening
Plain English, a few words. Used as the page title.
Sponsors
Assembly Member · Assembly District 25
15 Co-sponsors
History
- Referred to insurance
- Referred to insurance
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1807
2017-2018 Regular Sessions
IN ASSEMBLY
January 13, 2017
Introduced by M. of A. ROZIC, ABINANTI, AUBRY, BRONSON, COLTON, COOK, CRESPO, GRAF, JAFFEE, LUPINACCI, M. G. MILLER, O'DONNELL, OTIS, SEPULVEDA, SKOUFIS, WEPRIN -- Multi-Sponsored by -- M. of A. ARROYO, CROUCH, GUNTHER, KEARNS, McLAUGHLIN, PERRY, RAIA, RIVERA, SIMANOWITZ -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring health insurance policies to fully cover comprehensive genetic testing for breast, ovarian, prostate, colon and lung cancers in certain cases
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. This act shall be known and may be cited as the "Ana Lucia act".
§ 2. Paragraph 11 of subsection (i) of section 3216 of the insurance law is amended by adding a new subparagraph (G) to read as follows:
(G) (i) Such policy shall provide additional full coverage for comprehensive genetic testing for breast cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(ii) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
§ 3. Paragraph 11-a of subsection (i) of section 3216 of the insurance law is amended by adding a new subparagraph (C) to read as follows:
(C) (i) Such policy shall provide additional full coverage for comprehensive genetic testing for prostatic cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(ii) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
§ 4. Paragraph 11 of subsection (l) of section 3221 of the insurance law is amended by adding a new subparagraph (G) to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00894-01-7
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(G) (i) Such policy shall provide additional full coverage for comprehensive genetic testing for breast cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(ii) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
§ 5. Paragraph 11-a of subsection (l) of section 3221 of the insurance law is amended by adding a new subparagraph (C) to read as follows:
(C)(i) Such policy shall provide additional full coverage for comprehensive genetic testing for prostatic cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(ii) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
§ 6. Subsection (p) of section 4303 of the insurance law is amended by adding a new paragraph 6 to read as follows:
(6) (i) Such coverage shall provide additional full coverage for comprehensive genetic testing for breast cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(ii) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
§ 7. Subsection (z-1) of section 4303 of the insurance law is amended by adding a new paragraph 3 to read as follows:
(3)(A) Such policy shall provide additional full coverage for comprehensive genetic testing for prostatic cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(B) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
§ 8. Subsection (i) of section 3216 of the insurance law is amended by adding three new paragraphs 11-b, 11-c and 11-d to read as follows:
(11-b) (A) Every policy that provides coverage for hospital, surgical or medical care shall provide full coverage for genetic screening for ovarian cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(B) Such additional coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
(11-c) (A) Every policy that provides coverage for hospital, surgical or medical care shall provide full coverage for genetic screening for colon cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(B) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
(11-d) (A) Every policy that provides coverage for hospital, surgical or medical care shall provide full coverage for genetic screening for lung cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(B) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
§ 9. Subsection (l) of section 3221 of the insurance law is amended by adding three new paragraphs 11-b, 11-c and 11-d to read as follows:
(11-b) (A) Every insurer delivering a group or blanket policy or issuing a group or blanket policy for delivery in this state that provides
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coverage for hospital, surgical or medical care shall provide full coverage or genetic screening for ovarian cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(B) Such additional coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
(11-c) (A) Every policy that provides coverage for hospital, surgical or medical care shall provide full coverage for genetic screening for colon cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(B) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
(11-d) (A) Every policy that provides coverage for hospital, surgical or medical care shall provide full coverage for genetic screening for lung cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(B) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
§ 10. Section 4303 of the insurance law is amended by adding three new subsections (p-1), (p-2) and (p-3) 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 provide full coverage for genetic screening for ovarian cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(2) Such additional coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
(p-2) (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 provide full coverage for genetic screening for colon cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(2) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
(p-3) (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 provide full coverage for genetic screening for lung cancer only if recommended by a board-certified geneticist or a board-certified genetic counselor.
(2) All costs associated with such additional full coverage shall not be subject to annual deductibles and coinsurance but shall be borne solely by the insurer.
§ 11. This act shall take effect on the sixtieth day after it shall have become a law.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
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