What's happening
This bill requires health insurance policies in New York to cover diagnostic testing for ovarian cancer for certain women at increased risk.
Why it matters
Targets a high-risk group. The bill specifically ensures coverage for diagnostic ovarian cancer testing for women aged 40 and over who have at least one female relative with a history of ovarian cancer, aiming to catch the disease earlier in those most at risk.
Comprehensive test coverage. Required insurance coverage includes pelvic exams, sonograms, CA 125 blood tests, and any related lab or diagnostic services, potentially improving early detection and survival rates.
Uniformity across insurance types. The mandate applies to various insurance policy types—individual, group, and HMO plans—helping to close gaps in coverage and ensure consistency regardless of how someone is insured.
Financial barriers remain possible. While the bill mandates coverage, it allows insurers to apply deductibles and coinsurance consistent with other benefits, so patients may still face out-of-pocket costs, which could impact access for some.
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Who cares
Women aged 40 and older with a female relative who has had ovarian cancer
Those with covered policies would gain coverage for prescribed ovarian cancer diagnostic testing, potentially subject to annual deductibles and coinsurance.
Health insurers and health service corporations
Covered plans would have to cover pelvic examinations, sonograms, CA 125 blood tests and related laboratory and diagnostic services for eligible women.
Health care providers authorized to prescribe
Their prescriptions would trigger the required diagnostic testing coverage for eligible women.
State insurance superintendent
The bill would allow annual deductibles and coinsurance deemed appropriate by the superintendent and consistent with other benefits in the policy.
Headline styles
Cover Ovarian Cancer Testing
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Cover Ovarian Cancer Testing
In Assembly Committee · Insurance · Sponsor J. Gary Pretlow
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1162
2017-2018 Regular Sessions
IN SENATE
January 6, 2017
Introduced by Sen. CARLUCCI -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to health insurance coverage for diagnostic testing for ovarian cancer
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 delivered or issued for delivery in this state which provides medical coverage that includes coverage for physician services in a physician's office and every policy which provides major medical or similar comprehensive-type coverage shall provide, upon the prescription of a health care provider legally authorized to prescribe under title eight of the education law, coverage for diagnostic testing for ovarian cancer, including a pelvic examination, a sonogram, a CA 125 blood test and laboratory and diagnostic services provided in connection with examining and evaluating such blood test for women aged forty and over with one or more female relatives with a prior history of ovarian cancer.
(B) Such 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 which delivers or issues for delivery in this state a policy which provides medical coverage that includes coverage for physician services in a physician's office or major medical or similar comprehensive-type coverage shall provide, upon the prescription of a health care provider legally authorized to prescribe under title eight of the education law, coverage for diagnostic testing for ovarian cancer, including a pelvic examination, a sonogram, a CA 125 blood test
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01981-01-7
S. 1162 2
and laboratory and diagnostic services provided in connection with examining and evaluating such blood test for women aged forty and over with one or more female relatives with a prior history of ovarian cancer.
(B) Such 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 (oo) to read as follows:
(oo) (1) A hospital service corporation, medical expense indemnity corporation or health service corporation which provides medical coverage that includes coverage for physician services in a physician's office or major medical or similar comprehensive-type coverage shall provide, upon the prescription of a health care provider legally authorized to prescribe under title eight of the education law, coverage for diagnostic testing for ovarian cancer, including a pelvic examination, a sonogram, a CA 125 blood test and laboratory and diagnostic services provided in connection with examining and evaluating such blood test for women aged forty and over with one or more female relatives with a prior history of ovarian cancer.
(2) Such 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 first of January next succeeding the date on which it shall have become a law and shall apply to all policies issued, renewed, altered or modified on or after such effective date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the insurance law, in relation to health insurance coverage for diagnostic testing for ovarian cancer
Purpose or general idea of bill
To have every health insurance policy which provides coverage for hospital, surgical or medical care shall provide coverage for diagnostic testing for ovarian cancer.
Summary of specific provisions
Section one amends subsection (i) of section 3216 of the insurance law by adding a new paragraph 11-b to which requires every policy in this state providing medical coverage to carry coverage for ovarian cancer testing and screening.
Justification
Ovarian cancer gives no warning signs and is very difficult to detect. Early detection and treatment are the keys to stopping this deadly disease.
Prior legislative history
2015-16: S4730A/A917A - Insurance/Insurance
Fiscal implications
Minimal increase for state health plan.
Effective date
This act shall take effect on the first of January next succeeding the date on which it shall have become a law and shall apply to all policies issued, renewed, altered or modified on or after such effective date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.