Bill S543-2013

Requires providers of health care policies to provide coverage for colorectal cancer early detection

Requires providers of health care policies to provide coverage for colorectal cancer early detection for persons fifty years of age or older; requires the superintendent of insurance to provide notification to enrollees of such coverage via mail.

Details

Actions

  • Jan 8, 2014: REFERRED TO INSURANCE
  • Jan 9, 2013: REFERRED TO INSURANCE

Memo

BILL NUMBER:S543

TITLE OF BILL: An act to amend the insurance law, in relation to providing insurance coverage for colorectal cancer early detection

PURPOSE: This bill will require health insurance providers to cover the costs of colon screening by colonoscopy in men and women age 50 and older.

SUMMARY OF PROVISIONS: This bill amends paragraph 27 of subsection (i) of section 3216 of the insurance law, as added by chapter 457 of the laws of 2010, renumbered paragraph 30 and will add a new paragraph 32 to read as follows: (32) Every policy issued or delivered in this state shall provide coverage for colon cancer screening for persons fifty years of age or older. Such coverage shall include, but not be limited to, the costs of a colonoscopy or coloscopy.

JUSTIFICATION: Colon cancer is the second leading cancer killer in America and is the primary cancer killer among nonsmokers. Without preventative action, one in every 17 Americans will be diagnosed with colon cancer. However, with colonoscopy screening, that risk is reduced to as low as one in 100 people, Studies have found that a colonoscopy can detect cancer in patients without symptoms that would be missed by other screening methods. With such a preventative screening technique, cancer is detected earlier and treatment is more likely to be effective.

LEGISLATIVE HISTORY: 2012: S.6941 Referred to Insurance

FISCAL IMPLICATIONS: Any cost of enacting this legislation is far overshadowed by potential lives and dollars saved by early detection and treatment of colon cancer.

EFFECTIVE DATE: This act shall take effect immediately and shall apply to any policy issued, delivered, renewed, and/or modified on or after the effective date of this act.


Text

STATE OF NEW YORK ________________________________________________________________________ 543 2013-2014 Regular Sessions IN SENATE (PREFILED) January 9, 2013 ___________
Introduced by Sen. KENNEDY -- 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 providing insurance coverage for colorectal cancer early detection THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph 27 of subsection (i) of section 3216 of the insurance law, as added by chapter 457 of the laws of 2010, is renum- bered paragraph 30, paragraph 28 of subsection (i) of section 3216 of the insurance law, as amended by chapter 11 of the laws of 2012, is renumbered paragraph 31 and a new paragraph 32 is added to read as follows: (32) (A) EVERY POLICY WHICH PROVIDES COVERAGE PURSUANT TO THIS SECTION SHALL PROVIDE COVERAGE TO ANY NAMED SUBSCRIBER OR OTHER PERSON COVERED THEREUNDER FOR EXPENSES INCURRED IN CONDUCTING COLORECTAL CANCER EXAM- INATIONS AND LABORATORY TESTS AT REGULAR INTERVALS, INCLUDING EXPENSES INCURRED IN CONDUCTING PHYSICIAN CONSULTATIONS FOR COLORECTAL CANCER PRIOR TO SUCH EXAMINATIONS AND TESTS, FOR PERSONS FIFTY YEARS OF AGE OR OLDER AND FOR PERSONS OF ANY AGE WHO ARE CONSIDERED TO BE AT HIGH RISK FOR COLORECTAL CANCER. THE METHODS OF SCREENING FOR WHICH BENEFITS SHALL BE PROVIDED SHALL INCLUDE BUT NOT BE LIMITED TO: (I) A SCREENING FECAL OCCULT BLOOD TEST; (II) FLEXIBLE SIGMOIDOSCOPY; (III) COLONOSCOPY; (IV) BARIUM ENEMA; OR (V) THE MOST RELIABLE, MEDICALLY RECOGNIZED SCREENING TEST AVAILABLE; AND (VI) ANY COMBINATION THEREOF. THE METHOD AND FREQUENCY OF SCREENING TO BE UTILIZED SHALL BE IN ACCORD WITH THE MOST RECENTLY PUBLISHED GUIDELINES OF THE AMERICAN
COLLEGE OF GASTROENTEROLOGY OR THE AMERICAN GASTROENTEROLOGICAL ASSOCI- ATION IN CONSULTATION WITH THE AMERICAN CANCER SOCIETY. (B) AS USED IN THIS PARAGRAPH, "HIGH RISK FOR COLORECTAL CANCER" SHALL MEAN A PERSON HAS, (I) A FAMILY HISTORY OF FAMILIAL ADENOMATOUS POLYPOSIS; HEREDITARY NON-POLYPOSIS COLON CANCER; OR BREAST, OVARIAN, ENDOMETRIAL OR COLON CANCER OR POLYPS; (II) CHRONIC INFLAMMATORY BOWEL DISEASE; OR (III) A BACKGROUND, ETHNICITY OR LIFESTYLE THAT THE PHYSICIAN BELIEVES PUTS THE PERSON AT ELEVATED RISK FOR COLORECTAL CANCER. S 2. Subsection (k) of section 3221 of the insurance law is amended by adding a new paragraph 19 to read as follows: (19) (A) EVERY POLICY WHICH PROVIDES COVERAGE PURSUANT TO THIS SECTION SHALL PROVIDE COVERAGE TO ANY NAMED SUBSCRIBER OR OTHER PERSON COVERED THEREUNDER FOR EXPENSES INCURRED IN CONDUCTING COLORECTAL CANCER EXAM- INATIONS AND LABORATORY TESTS AT REGULAR INTERVALS, INCLUDING EXPENSES INCURRED IN CONDUCTING PHYSICIAN CONSULTATIONS FOR COLORECTAL CANCER PRIOR TO SUCH EXAMINATIONS AND TESTS, FOR PERSONS FIFTY YEARS OF AGE OR OLDER AND FOR PERSONS OF ANY AGE WHO ARE CONSIDERED TO BE AT HIGH RISK FOR COLORECTAL CANCER. THE METHODS OF SCREENING FOR WHICH BENEFITS SHALL BE PROVIDED SHALL INCLUDE BUT NOT BE LIMITED TO: (I) A SCREENING FECAL OCCULT BLOOD TEST; (II) FLEXIBLE SIGMOIDOSCOPY; (III) COLONOSCOPY; (IV) BARIUM ENEMA; OR (V) THE MOST RELIABLE, MEDICALLY RECOGNIZED SCREENING TEST AVAILABLE; AND (VI) ANY COMBINATION THEREOF. THE METHOD AND FREQUENCY OF SCREENING TO BE UTILIZED SHALL BE IN ACCORD WITH THE MOST RECENTLY PUBLISHED GUIDELINES OF THE AMERICAN COLLEGE OF GASTROENTEROLOGY OR THE AMERICAN GASTROENTEROLOGICAL ASSOCI- ATION IN CONSULTATION WITH THE AMERICAN CANCER SOCIETY. (B) AS USED IN THIS PARAGRAPH, "HIGH RISK FOR COLORECTAL CANCER" SHALL MEAN A PERSON HAS, (I) A FAMILY HISTORY OF FAMILIAL ADENOMATOUS POLYPOSIS; HEREDITARY NON-POLYPOSIS COLON CANCER; OR BREAST, OVARIAN, ENDOMETRIAL OR COLON CANCER OR POLYPS; (II) CHRONIC INFLAMMATORY BOWEL DISEASE; OR (III) A BACKGROUND, ETHNICITY OR LIFESTYLE THAT THE PHYSICIAN BELIEVES PUTS THE PERSON AT ELEVATED RISK FOR COLORECTAL CANCER. S 3. Subsection (a) of section 4303 of the insurance law is amended by adding a new paragraph 4 to read as follows: (4) TO PERSONS FIFTY YEARS OF AGE OR OLDER FOR SERVICES RELATED TO THE CONDUCTING OF COLORECTAL CANCER EXAMINATIONS AND LABORATORY TESTS AT REGULAR INTERVALS, INCLUDING EXPENSES INCURRED IN CONDUCTING PHYSICIAN CONSULTATIONS FOR COLORECTAL CANCER PRIOR TO SUCH EXAMINATIONS AND TESTS, INCLUDING BUT NOT LIMITED TO, COLONOSCOPIES, COLOSCOPIES, SCREEN- ING FECAL OCCULT BLOOD TESTS, FLEXIBLE SIGMOIDOSCOPIES OR BARIUM ENEMAS. S 4. The superintendent of financial services shall require an insur- er, health carrier or health benefit plan to notify enrollees annually of colorectal cancer screenings covered by such enrollees' health bene- fit plan and the most recently published guidelines of the American College of Gastroenterology or the American Gastroenterological Associ- ation in consultation with the American Cancer Society for colorectal cancer screenings or notify enrollees at intervals consistent with the most recently published guidelines of the American College of Gastroen-
terology or the American Gastroenterological Association in consultation with the American Cancer Society of colorectal cancer screenings which are covered by such enrollees' health benefit plans. The notice shall be delivered by mail unless the enrollee and health carrier have agreed on another method of notification. The superintendent of financial services is authorized to promulgate necessary rules and regulations for the purposes of providing such notification. S 5. This act shall take effect immediately and shall apply to any policy issued, delivered, renewed, and/or modified on or after the effective date of this act.

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