What's happening
This bill requires health insurance policies in New York to cover follow-up lung cancer screenings with no patient cost sharing, starting January 1, 2027.
Why it matters
Removes financial barriers. By eliminating patient cost-sharing for follow-up lung cancer screenings, the bill ensures individuals are not discouraged from necessary diagnostic care due to out-of-pocket expenses, potentially leading to earlier detection and better outcomes.
Aligns care with best practices. Coverage is tied to recommendations made by licensed providers following evidence-based, nationally recognized clinical guidelines, helping standardize care and reduce unnecessary or outdated procedures.
Clarifies insurer responsibilities and limits. While insurers must cover follow-up screenings without cost-sharing, the bill explicitly allows for medical management and preauthorization, meaning insurers can still use utilization review to ensure services are medically appropriate and guideline-consistent.
Protects health savings account eligibility. For those with high-deductible health plans, the bill permits cost-sharing for these screenings only if waiving it would make the policyholder ineligible for a Health Savings Account, preserving an important tax-advantaged benefit.
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Who cares
Headline styles
Cover Lung Cancer Screenings
Plain English, a few words. Used as the page title.
Sponsors
History
- Substituted by A1195A
- Amended on third reading (t) 2000a
- Vote reconsidered - restored to third reading
- Returned to senate
- Recalled from assembly
- Referred to insurance
- Delivered to assembly
- Passed senateVote 61–0
- Advanced to third reading
- 2nd report cal.
- 1st report cal.235
- 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 Lung Cancer Screenings
Signed by Governor · Sponsor Crystal Peoples-Stokes
Full text
3 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
2000--A Cal. No. 235
2025-2026 Regular Sessions
IN SENATE
January 14, 2025
Introduced by Sens. ADDABBO, CLEARE, COMRIE, COONEY, HARCKHAM, PARKER, SALAZAR, SKOUFIS -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- reported favorably from said committee, ordered to first and second report, ordered to a third reading, passed by Senate and delivered to the Assembly, recalled, vote reconsidered, restored to third reading, amended and ordered reprinted, retaining its place in the order of third reading
AN ACT to amend the insurance law, in relation to mandatory health insurance coverage for follow-up screening or diagnostic services for lung 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 41 to read as follows:
(41) (A) Every policy which provides medical, major medical, or similar comprehensive-type coverage shall provide coverage for follow-up screening or diagnostic services for lung cancer upon the recommendation of a health care provider acting within the provider's scope of practice pursuant to title eight of the education law, and as recommended by nationally recognized clinical practice guidelines for the detection of lung cancer.
(B) Notwithstanding any other provision of law, any policy that provides coverage required by this paragraph shall not impose patient cost sharing for follow-up screening or diagnostic services for lung cancer.
(C) For the purposes of this paragraph, "nationally recognized clinical practice guidelines" means evidence-based, peer reviewed clinical practice guidelines informed by a systematic review of evidence and an assessment of the benefits, and risks of alternative care options intended to optimize patient care developed by independent organizations
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02876-03-5
or medical professional societies utilizing a transparent methodology and reporting structure and with a conflict of interest policy.
(D) Nothing in this paragraph shall be construed to prevent medical management or utilization review of the services, including preauthorization, to ensure that such services are consistent with nationally recognized clinical practice guidelines for the detection of lung cancer.
(E) If the policy is a high deductible health plan as defined in section 223(c)(2) of the Internal Revenue Code of 1986, such coverage may be subject to the plan's annual deductible if application of this requirement would result in ineligibility for a health savings account.
§ 2. Subsection (l) of section 3221 of the insurance law is amended by adding a new paragraph 23 to read as follows:
(23) (A) Every policy which provides medical, major medical, or similar comprehensive-type coverage shall provide coverage for follow-up screening or diagnostic services for lung cancer upon the recommendation of a health care provider acting within the provider's scope of practice pursuant to title eight of the education law, and as recommended by nationally recognized clinical practice guidelines for the detection of lung cancer.
(B) Notwithstanding any other provision of law, any policy that provides coverage required by this paragraph shall not impose patient cost sharing for follow-up screening or diagnostic services for lung cancer.
(C) For the purposes of this paragraph, "nationally recognized clinical practice guidelines" means evidence-based, peer reviewed clinical practice guidelines informed by a systematic review of evidence and an assessment of the benefits, and risks of alternative care options intended to optimize patient care developed by independent organizations or medical professional societies utilizing a transparent methodology and reporting structure and with a conflict of interest policy.
(D) Nothing in this paragraph shall be construed to prevent medical management or utilization review of the services, including preauthorization, to ensure that such services are consistent with nationally recognized clinical practice guidelines for the detection of lung cancer.
(E) If the policy is a high deductible health plan as defined in section 223(c)(2) of the Internal Revenue Code of 1986, such coverage may be subject to the plan's annual deductible if application of this requirement would result in ineligibility for a health savings account.
§ 3. Section 4303 of the insurance law is amended by adding a new subsection (ww) to read as follows:
(ww) (1) Every policy which provides medical, major medical, or similar comprehensive-type coverage shall provide coverage for follow-up screening or diagnostic services for lung cancer upon the recommendation of a health care provider acting within the provider's scope of practice pursuant to title eight of the education law, and as recommended by nationally recognized clinical practice guidelines for the detection of lung cancer.
(2) Notwithstanding any other provision of law, any policy that provides coverage required by this subsection shall not impose patient cost sharing for follow-up screening or diagnostic services for lung cancer.
(3) For the purposes of this paragraph, "nationally recognized clinical practice guidelines" means evidence-based, peer reviewed clinical practice guidelines informed by a systematic review of evidence and an assessment of the benefits, and risks of alternative care options intended to optimize patient care developed by independent organizations or medical professional societies utilizing a transparent methodology and reporting structure and with a conflict of interest policy.
(4) Nothing in this paragraph shall be construed to prevent medical management or utilization review of the services, including preauthorization, to ensure that such services are consistent with nationally recognized clinical practice guidelines for the detection of lung cancer.
(5) If the policy is a high deductible health plan as defined in section 223(c)(2) of the Internal Revenue Code of 1986, such coverage may be subject to the plan's annual deductible if application of this requirement would result in ineligibility for a health savings account.
§ 4. This act shall take effect January 1, 2027 and shall apply to all policies and contracts issued, renewed, modified, altered or amended on or after such 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 mandatory health insurance coverage for follow-up screening or diagnostic services for lung cancer
Purpose
Lung cancer is one of the most common cancers among New Yorkers. In New York it is the leading cause of cancer deaths. Each year over 6,700 men and over 7,200 women are diagnosed with lung cancer and about 3,800 men and over 3,600 women die from this disease. In New York State, lung cancer death rates among men and women have been declining since 1995, but the decline among women has been slower. It is hard to detect lung cancer early without a screening test. This is because symptoms usually do not show until the cancer has reached later stages, when it is more difficult to treat. This bill will provide comprehensive-type coverage for lung cancer screenings and increase access to these life savings screenings. Access to cancer screening, follow-up testing, and treatment should not depend on a patient's ability to pay.
Summary of provisions
Section 1: Amends section 3216 of the insurance law by adding a new paragraph.
Section 2: Amends section 3221 of the insurance law by adding a new paragraph.
Section 3: Amends section 4303 of the insurance law by adding a new subsection(vv)
Section 4: would set the effective date.
Justification
In 2024, an estimated 14,200 New Yorkers were diagnosed with lung cancer including 6,600 men and over 7,600 women and about 6,100 died from the disease including about 3,100 men and over 3,000 women. Screening for lung cancer with annual low-dose CT scans among those at high risk can reduce the lung cancer death rate by up to 20% by detecting the disease at early stages when it is more likely to be curable. For screening to be most effective in reducing the overall lung cancer mortality rate, more of the high-risk population should be screened - currently screen- ing rates are very low among those at high risk. This may be because of a lack of access or low awareness and knowledge among patients and providers. Rates vary tremendously between states and more can be done to increase screening rates. In New York, 19.3% of those at high risk for lung cancer were screened, which was not significantly different than the national rate of 16.0%.
Legislative history
2023-24: S.8553C - Passed Senate
Fiscal implications
None
Effective date
This act shall take effect on January 1, 2027 and shall apply to all policies and contracts issued, renewed, modified, altered or amended on or after such date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.