What's happening
This bill requires testing for dihydropyrimidine dehydrogenase deficiency before certain chemotherapy treatments and mandates insurance coverage for such testing.
Why it matters
Aims to reduce severe side effects and potentially fatal reactions. by ensuring patients are screened for dihydropyrimidine dehydrogenase (DPD) deficiency before receiving certain common chemotherapy drugs (fluoropyrimidines and other antimetabolites), which can be highly toxic to those with this deficiency.
Standardizes care and closes gaps in patient safety. by mandating that all practitioners, not just some, perform DPD deficiency testing prior to administering relevant chemotherapy, addressing inconsistencies in current clinical practice.
Removes financial barriers to essential pre-treatment testing. by requiring both private health insurers and Medicaid to cover DPD deficiency testing, so patients are not deterred from receiving a potentially life-saving test due to cost.
Could help personalize cancer treatment. by identifying patients who may need alternative chemotherapy regimens or dose adjustments, fostering safer and more effective cancer care.
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Who cares
Headline styles
Require Cancer Drug Safety Testing
Plain English, a few words. Used as the page title.
Sponsors
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History
- Referred to health
- Recommitted to rules
- Ordered to third reading cal.330
- Committee discharged and committed to rules
- Reported and committed to finance
- Referred to health
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.
Require Cancer Genetic Testing
In Assembly Committee · Health · Sponsor Patricia Fahy
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
984
2019-2020 Regular Sessions
IN SENATE
January 9, 2019
Introduced by Sen. BRESLIN -- read twice and ordered printed, and when printed to be committed to the Committee on Health
AN ACT to amend the public health law, in relation to requiring dihydropyrimidine dehydrogenase deficiency testing for certain individuals with cancer; to amend the insurance law, in relation to requiring policies and contracts of insurance to include coverage for dihydropyrimidine dehydrogenase deficiency testing; and to amend the social services law, in relation to the provision of dihydropyrimidine dehydrogenase deficiency testing under the medical assistance program
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The public health law is amended by adding a new section 2400-a to read as follows:
§ 2400-a. Dihydropyrimidine dehydrogenase deficiency testing. 1. For purposes of this section the following terms shall have the following meanings:
(a) "Antimetabolites" means a substance that interferes with the normal metabolic processes within cells, typically by combining with enzymes.
(b) "Dihydropyrimidine dehydrogenase deficiency" means a condition in which the body cannot break down the nucleotides thymine and uracil.
(c) "Fluoropyrmidine" means a group of substances used to treat cancer through chemotherapy.
2. Every physician or other authorized practitioner who provides fluoropyrmidine or other antimetabolites to individuals diagnosed with cancer shall test for dihydropyrimidine dehydrogenase deficiency prior to such treatment.
§ 2. Subparagraph (A) of paragraph 12-a of subsection (i) of section 3216 of the insurance law, as amended by chapter 12 of the laws of 2012, is amended to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02330-01-9
S. 984 2
(A) Every policy delivered or issued for delivery in this state that provides medical, major medical, or similar comprehensive-type coverage and provides coverage for prescription drugs and also provides coverage for cancer chemotherapy treatment shall provide coverage for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells, and shall provide coverage for dihydropyrimidine dehydrogenase deficiency testing prior to such treatment where such treatment consists of fluoropyrmidine or other antimetabolites. Such coverage may be subject to co-pays, coinsurance or deductibles, provided that the co-pays, coinsurance or deductibles are at least as favorable to an insured as the co-pays, coinsurance or deductibles that apply to coverage for intravenous or injected anticancer medications.
§ 3. Subparagraph (A) of paragraph 12-a of subsection (l) of section 3221 of the insurance law, as amended by chapter 12 of the laws of 2012, is amended to read as follows:
(A) Every policy delivered or issued for delivery in this state that provides medical, major medical, or similar comprehensive-type coverage and provides coverage for prescription drugs and also provides coverage for cancer chemotherapy treatment shall provide coverage for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells, and shall provide coverage for dihydropyrimidine dehydrogenase deficiency testing prior to such treatment where such treatment consists of fluoropyrmidine or other antimetabolites. Such coverage may be subject to co-pays, coinsurance or deductibles, provided that the co-pays, coinsurance or deductibles are at least as favorable to an insured as the co-pays, coinsurance or deductibles that apply to coverage for intravenous or injected anticancer medications.
§ 4. Paragraph 1 of subsection (q-1) of section 4303 of the insurance law, as amended by chapter 12 of the laws of 2012, is amended to read as follows:
(1) Every contract issued by a medical expense indemnity corporation, a hospital service corporation or a health service corporation for delivery in this state that provides medical, major medical or similar comprehensive-type coverage and provides coverage for prescription drugs and for cancer chemotherapy treatment shall provide coverage for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells, and shall provide coverage for dihydropyrimidine dehydrogenase deficiency testing prior to such treatment where such treatment consists of fluoropyrmidine or other antimetabolites. Such coverage may be subject to co-pays, coinsurance or deductibles, provided that the co-pays, coinsurance or deductibles are at least as favorable to an insured as the co-pays, coinsurance or deductibles that apply to coverage for intravenous or injected anticancer medications.
§ 5. The social services law is amended by adding a new section 365-o to read as follows:
§ 365-o. Provision of dihydropyrimidine dehydrogenase deficiency testing. 1. The commissioner shall establish standards and guidelines for the provision of dihydropyrimidine dehydrogenase deficiency testing prior to cancer treatment through fluoropyrmidine or other antimetabolites under the medical assistance program.
2. For purposes of this section:
(a) "Antimetabolites" means a substance that interferes with the normal metabolic processes within cells, typically by combining with enzymes.
S. 984 3
(b) "Dihydropyrimidine dehydrogenase deficiency" means a condition in which the body cannot break down the nucleotides thymine and uracil.
(c) "Fluoropyrmidine" means a group of substances used to treat cancer through chemotherapy.
§ 6. This act shall take effect on the one hundred twentieth day after it shall have become a law. Effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized to be made and completed on or before 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 public health law, in relation to requiring dihydro- pyrimidine dehydrogenase deficiency testing for certain individuals with cancer; to amend the insurance law, in relation to requiring policies and contracts of insurance to include coverage for dihydropyrimidine dehydrogenase deficiency testing; and to amend the social services law, in relation to the provision of dihydropyrimidine dehydrogenase defi- ciency testing under the medical assistance program
Purpose or general idea of bill
To allow cancer patients being treated with chemotherapy involving Fluo- rouracil (5F0) to be tested for Dihydropyrimidine Dehydrogenase Defi- ciency (DPD) prior to treatment.
Summary of specific provisions
Section One amends the public health law by adding a new section, 2400-a, which will define terms and language used in the bill, and will require every physician or other authorized practitioner who provides fluoropyrmidine or other antimetabolites to individuals diagnosed with cancer to test for Dihydropyrimidine Dehydrogenase Deficiency prior to such treatments.
Section Two amends subparagraph (A) of paragraph 12-a of subsection (i) of section 3216 of the Insurance Law, as amended by chapter 12 of the laws of 2012 to provide coverage for Dihydropyrimidine Dehydrogenase Deficiency testing prior to such treatments where such treatment consists of Fluoropyrmidine or other antimetabolites.
Section three amends subparagraph (A) of paragraph 12-a of subsection (1) of section 3221 of the insurance law, as amended by chapter 12 of the laws of 2012 to provide coverage for Dihydropyrimidine Dehydrogenase Deficiency testing prior to such treatments where such treatment consists of Fluoropyrmidine or other antimetabolites.
Section four amends paragraph 1 of subsection (q-1) of section 4303 of the insurance law, as amended by chapter 12 of the laws of 2012 to provide coverage for Dihydropyrimidine Dehydrogenase Deficiency testing prior to such treatments where such treatment consists of Fluoropyrmi- dine or other antimetabolites.
Section five amends the social services law by adding a new section 365-o, which will define terms and language used in the bill, and will require the commissioner to establish standards and guidelines for the provision of Dihydropyrimidine Dehydrogenase Deficiency testing prior to cancer treatments through fluoropyrmidine or other antimetabolites under the medical assistance program.
Section six establishes the effective date.
Justification
Dihydropyrimidine dehydrogenase (DPD) is an enzyme our bodies make that helps us process thymine and uracil, which are a part of the structure of our genes. DPD also helps us break down the chemotherapy drug fluo- rouracil. If a cancer patient with a DPD deficiency is exposed to a chemotherapy drug like fluorouracil, it can result in death, as the body is not able to break down and metabolize the drug and the drug will build up in the body.
A patient is more likely to have severe side effects from chemotherapy drugs if they have low levels (a deficiency) of DPD, thus testing for it could help identify if using a chemotherapy drug right away is the best practice.
Recently, a rapid, non-invasive and cost-effective breath test has been developed which permits the evaluation of DPD in the body before a potentially potent drug is used for cancer treatment.
Prior legislative history
2017/2018: S.7710, Passed Senate Unanimously, referred to Assembly Health
Effective date
This act shall take effect on the one hundred twentieth day after it shall have become law. Effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized to be made and completed on or before such effective date.
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