What's happening
This bill requires health insurance policies in New York to cover diagnostic testing for ovarian cancer for certain women at higher risk.
Why it matters
Targets women at increased risk. The bill specifically requires coverage for diagnostic ovarian cancer testing only for women aged 40 and over who have at least one female relative with a prior history of ovarian cancer, addressing a high-risk group.
Mandates a range of diagnostic services. Coverage must include not just one test, but a pelvic exam, sonogram, CA 125 blood test, and related laboratory and diagnostic services—potentially improving early detection and outcomes for at-risk women.
Limits patient financial burden, but not entirely. While insurance must cover these tests, insurers can still apply deductibles and coinsurance similar to other benefits, meaning some out-of-pocket costs may remain for patients.
Standardizes insurance obligations. The bill amends multiple types of insurance policies (individual, group, and nonprofit health plans), ensuring consistent coverage requirements across the state's insurance marketplace for the specified population.
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Who cares
Headline styles
Cover Ovarian Cancer Testing
Plain English, a few words. Used as the page title.
Sponsors
Senator · Senate District 38
1 Co-sponsor
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
526
2019-2020 Regular Sessions
IN SENATE (Prefiled)
January 9, 2019
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
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04751-01-9
S. 526 2
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.
§ 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.
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 hospi- tal, 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
2017-18: S1162/1745 - INSURANCE/insurance 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.