What's happening
This bill requires health insurance policies in New York to cover comprehensive ovarian cancer screening and testing in specified cases.
Why it matters
Expands access to early detection tools. for ovarian cancer by requiring coverage not just for standard pelvic exams, but also for genetic testing, ultrasounds, and blood tests—especially for those at higher risk or with a family history—potentially catching cancer earlier when treatment is more effective.
Mandates regular, age-based screening. by requiring a baseline ultrasound for women aged 35-39 and annual ultrasounds for those 40 and older, which could lead to earlier diagnosis in populations that might otherwise be overlooked.
Requires coverage of advanced diagnostic procedures. (such as CT scans, MRIs, PET scans, colonoscopies, and biopsies) for individuals identified as higher risk, ensuring that those with concerning findings or genetic predispositions are not blocked by cost from further necessary testing.
Allows for deductibles and coinsurance. but only as consistent with other health benefits, meaning cost-sharing is controlled and should not be higher than for comparable services—potentially reducing out-of-pocket burdens for patients undergoing ovarian cancer screening.
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Who cares
Headline styles
Cover Ovarian Cancer Screenings
Plain English, a few words. Used as the page title.
Sponsors
Assembly Member · Assembly District 25
23 Co-sponsors
- Jeffrion Aubry
- Thomas Abinanti
- Brian Barnwell
- William Colton
- Vivian Cook
- Marcos Crespo
- Aileen Gunther
- Ellen C. Jaffee
- Billy Jones
- Michael Montesano
- Steven Otis
- N. Nick Perry
- Luis R. Sepúlveda
- James Skoufis
- Phil Steck
- Michele Titus
- David Weprin
- Jo Anne Simon
- Ron Castorina Jr.
- Anthony D'Urso
- Michael Blake
- Crystal Peoples-Stokes
- Michael G. Miller
History
- Referred to insurance
- Referred to insurance
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1882
2017-2018 Regular Sessions
IN ASSEMBLY
January 13, 2017
Introduced by M. of A. ROZIC, AUBRY, ABINANTI, BARNWELL, COLTON, COOK, CRESPO, GRAF, GUNTHER, JAFFEE, JONES, LUPINACCI, MONTESANO, MOYA, OTIS, PERRY, SEPULVEDA, SKOUFIS, STECK, TITUS, WEPRIN -- Multi-Sponsored by -- M. of A. ARROYO, CROUCH, MAGEE, MOSLEY, RA, RIVERA, SIMA- NOWITZ, SKARTADOS, TITONE -- read once and referred to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring health insurance policies to cover comprehensive tests for ovarian cancer in certain cases
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 11-b to read as follows:
(11-b) (A) Every policy that provides coverage for hospital, surgical or medical care shall provide the following coverage for screening for ovarian cancer:
(i) upon the recommendation of a physician, a pelvic exam, genetic testing, ultrasound and blood testing at any age for covered persons having a high risk of developing ovarian cancer or who have a first degree relative with a prior history of ovarian cancer;
(ii) a single baseline ultrasound for covered persons aged thirty-five through thirty-nine, inclusive; and
(iii) an annual ultrasound for covered persons aged forty and older.
(B) Such coverage required pursuant to subparagraph (A) of this paragraph may be subject to annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other benefits within a given policy.
(C) (i) Such policy shall provide for additional coverage for computed tomography, barium enema X-rays, magnetic resonance imaging (MRI), positron emission tomography, laparoscopy, colonoscopy and biopsy if a person is believed to be at increased risk for ovarian cancer due to
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00873-01-7
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family history or prior personal history of ovarian cancer, positive genetic testing or other indications as determined by such person's physician or nurse practitioner.
(ii) Such additional coverage may be subject to annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other benefits within a given policy.
§ 2. Subsection (l) of section 3221 of the insurance law is amended by adding a new paragraph 11-b 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 coverage for hospital, surgical or medical care shall provide the following coverage for screening for ovarian cancer:
(i) upon the recommendation of a physician, a pelvic exam, genetic testing, ultrasound and blood testing at any age for covered persons having a high risk of developing ovarian cancer or who have a first degree relative with a prior history of ovarian cancer;
(ii) a single baseline ultrasound for covered persons aged thirty-five through thirty-nine, inclusive; and
(iii) an annual ultrasound for covered persons aged forty and older.
(B) Such coverage required pursuant to subparagraph (A) of this paragraph may be subject to annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other benefits within a given policy.
(C) (i) Such policy shall provide for additional coverage for computed tomography, barium enema X-rays, magnetic resonance imaging (MRI), positron emission tomography, laparoscopy, colonoscopy and biopsy if a person is believed to be at increased risk for ovarian cancer due to family history or prior personal history of ovarian cancer, positive genetic testing or other indications as determined by such person's physician or nurse practitioner.
(ii) Such additional coverage may be subject to annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other benefits within a given policy.
§ 3. Section 4303 of the insurance law is amended by adding a new subsection (p-1) 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 the following coverage for screening for ovarian cancer:
(A) upon the recommendation of a physician, a pelvic exam, genetic testing, ultrasound and blood testing at any age for covered persons having a high risk of developing ovarian cancer or who have a first degree relative with a prior history of ovarian cancer;
(B) a single baseline ultrasound for covered persons aged thirty-five through thirty-nine, inclusive; and
(C) an annual ultrasound for covered persons aged forty and older.
(2) Such coverage required pursuant to subparagraph (A) of this paragraph may be subject to annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other benefits within a given policy.
(3) (A) Such policy shall provide for additional coverage for computed tomography, barium enema X-rays, magnetic resonance imaging (MRI), positron emission tomography, laparoscopy, colonoscopy and biopsy if a person is believed to be at increased risk for ovarian cancer due to
A. 1882 3
family history or prior personal history of ovarian cancer, positive genetic testing or other indications as determined by such person's physician or nurse practitioner.
(B) Such additional coverage may be subject to annual deductibles and coinsurance as may be deemed appropriate by the superintendent and as are consistent with those established for other benefits within a given policy.
§ 4. 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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