What's happening
This bill requires health insurance policies in New York to cover diagnostic testing for ovarian cancer in certain at-risk women.
Why it matters
Targets high-risk women. The bill specifically mandates coverage for women aged 40 and over who have at least one female relative with a history of ovarian cancer, addressing a population with elevated risk and potential for earlier detection.
Comprehensive diagnostic approach. Insurers must cover not just one test, but a suite of recognized diagnostic tools (pelvic exams, sonograms, CA 125 blood tests, and related lab and diagnostic services), which may improve the chances of identifying ovarian cancer in its early, more treatable stages.
Standardizes insurance requirements. By amending multiple sections of the insurance law, the bill ensures consistent application across various types of insurance policies (individual, group, hospital/medical service corporations), reducing gaps in access to these life-saving tests.
Potential cost implications for patients and insurers. While the bill allows for deductibles and coinsurance, it aligns these costs with existing policy structures—potentially increasing upfront access for at-risk women while also impacting insurance plan pricing and utilization patterns.
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Who cares
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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 Senate Committee · Insurance · Sponsor David Carlucci
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
3684
2019-2020 Regular Sessions
IN ASSEMBLY
January 30, 2019
Introduced by M. of A. PRETLOW -- read once and referred 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.
LBD04751-01-9
A. 3684 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 (ss) to read as follows:
(ss) (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.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.