NY State Senate Bill 2015-S3454

Senate Bill S3454

2015-2016 Legislative Session

Requires insurance coverage for the HALO breast pap test to detect risk of developing breast cancer

download bill text pdf

Archive: Last Bill Status - In Senate Committee Insurance Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 06, 2016	referred to insurance
Feb 09, 2015	referred to insurance

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2015-S3454 (ACTIVE) - Details

See Assembly Version of this Bill:: A1840
Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L
Versions Introduced in Other Legislative Sessions:: 2009-2010: A10136
2011-2012: A404
2013-2014: S5337, A1702
2017-2018: A717
2019-2020: A2346
2021-2022: A5198
2023-2024: A4361

2015-S3454 (ACTIVE) - Summary

Requires insurance coverage for the HALO breast pap test to detect risk of developing breast cancer.

2015-S3454 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S3454

TITLE OF BILL:  An act to amend the insurance law, in relation to
coverage for the HALO breast pap test to detect risk of developing
breast cancer

PURPOSE:

To require insurance coverage for the HALO breast pap test to detect
risk of developing breast cancer.

SUMMARY OF PROVISIONS:

Section 1 amends subsection (i) of section 3216 of the insurance law
by adding a new paragraph 32 which requires every policy which
provides coverage for hospital, surgical, or medical care coverage
also provide coverage for the HALO breast pap test, when such test is
recommended by a physician.

Section 2 amends subsection (1) of section 3221 of the insurance law
by adding a new paragraph 19 which requires any group or blanket
accident or health insurance policy or issuing a group blanket policy
for delivery in this state which provides coverage for hospital,
surgical, or medical care coverage also provide coverage for the HALO
breast pap test, when such test is recommended by a physician.

Section 3 amends section 4303 of the insurance law by adding a new
subsection (pp) which requires any medical expense indemnity
corporation, hospital service corporation or a health service
corporation which provides coverage for hospital, surgical, or medical
care coverage also provide coverage for the HALO breast pap test, when
such test is recommended by a physician.

Section 4 is the effective date.

JUSTIFICATION:

HALO is the only FDA-cleared risk assessment tool for non-hereditary
breast cancer. By collecting nipple aspirate fluid (NAF) for
cytological evaluation, HALO helps identify precancerous changes at
the cellular level years before a potentially cancerous lesion might
form. Multiple clinical studies concur that women with these cellular
abnormalities are four to five times more likely to develop future
breast cancer.

One in eight women will develop breast cancer in her lifetime, but to
date, ifs been very difficult to identify who is at risk, so we wait
for lumps before intervening. Traditional methods of breast cancer
screening, mammograms and breast exams, find cancers that have been
growing, on average, for eight to ten years. Also, standard film
mammography is not as effective in women under 50 with dense breasts,
and misses up to 73 percent of cancers in this group, which is one
reason for the recent controversy over its use. HALO is a risk
assessment tool that can help identify women at greatest risk, years
earlier, allowing for earlier intervention and increasing chances for
prevention and survival.  Knowing who is at greatest risk helps us
focus or a limited resources on the right women.


LEGISLATIVE HISTORY:

2013-14 - died in Insurance Committee in both Houses.

FISCAL IMPLICATIONS:

None

EFFECTIVE DATE:

This act shall take effect on the first of January next succeeding the
date on which it shall become a law and apply to all policies or
contracts issued, renewed, modified, altered or amended on and after
such effective date.

2015-S3454 (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  3454

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            February 9, 2015
                               ___________

Introduced  by  Sen.  SAVINO -- 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 coverage for the  HALO
  breast pap test to detect risk of developing breast cancer

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subsection (i) of section 3216  of  the  insurance  law  is
amended by adding a new paragraph 32 to read as follows:
  (32)  (A) EVERY POLICY WHICH PROVIDES COVERAGE FOR HOSPITAL, SURGICAL,
OR MEDICAL CARE COVERAGE SHALL PROVIDE COVERAGE FOR THE HALO BREAST  PAP
TEST  TO  DETECT  A  WOMAN'S RISK OF DEVELOPING BREAST CANCER, WHEN SUCH
TEST IS RECOMMENDED BY A PHYSICIAN OR CERTIFIED NURSE PRACTITIONER.
  (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.
  (C) FOR PURPOSES OF THIS SECTION,  "HALO  BREAST  PAP  TEST"  MEANS  A
PROCEDURE THAT ENTAILS COLLECTION OF NIPPLE ASPIRATE FLUID FOR CYTOLOGI-
CAL EVALUATION.
  S 2. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 19 to read as follows:
  (19)  (A)  A  GROUP  OR BLANKET ACCIDENT OR HEALTH INSURANCE POLICY OR
ISSUING A GROUP BLANKET POLICY FOR DELIVERY IN THIS STATE WHICH PROVIDES
COVERAGE FOR HOSPITAL, SURGICAL, OR MEDICAL CARE COVERAGE SHALL  PROVIDE
COVERAGE FOR THE HALO BREAST PAP TEST TO DETECT A WOMAN'S RISK OF DEVEL-
OPING  BREAST  CANCER,  WHEN  SUCH TEST IS RECOMMENDED BY A PHYSICIAN OR
CERTIFIED NURSE PRACTITIONER.
  (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 GIVEN A GIVEN POLICY.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD01595-02-5

S. 3454                             2

  (C) FOR PURPOSES OF THIS SECTION,  "HALO  BREAST  PAP  TEST"  MEANS  A
PROCEDURE THAT ENTAILS COLLECTION OF NIPPLE ASPIRATE FLUID FOR CYTOLOGI-
CAL EVALUATION.
  S  3.  Section  4303  of  the insurance law is amended by adding a new
subsection (pp) to read as follows:
  (PP)(1) A MEDICAL EXPENSE INDEMNITY CORPORATION,  A  HOSPITAL  SERVICE
CORPORATION  OR A HEALTH SERVICE CORPORATION WHICH PROVIDES COVERAGE FOR
HOSPITAL, SURGICAL, OR MEDICAL CARE COVERAGE SHALL PROVIDE COVERAGE  FOR
THE  HALO  BREAST PAP TEST TO DETECT A WOMAN'S RISK OF DEVELOPING BREAST
CANCER, WHEN SUCH TEST IS RECOMMENDED BY A PHYSICIAN OR CERTIFIED  NURSE
PRACTITIONER.
  (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.
  (3)  FOR  PURPOSES  OF  THIS  SECTION,  "HALO BREAST PAP TEST" MEANS A
PROCEDURE THAT ENTAILS COLLECTION OF NIPPLE ASPIRATE FLUID FOR CYTOLOGI-
CAL EVALUATION.
  S 4. This act shall take effect on the first of January next  succeed-
ing  the date on which it shall have become a law and shall apply to all
policies or contracts issued, renewed, modified, altered or  amended  on
and after such effective date.

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