Bill S6603-2011

Requires coverage for cervical cytology screening for insureds by certain corporations and insurance policies

Requires coverage for cervical cytology screening for insureds by certain corporations and insurance policies: every policy with hospital, surgical or medical care, group or blanket policy, and medical expense indemnity corporation.

Details

Actions

  • Mar 2, 2012: REFERRED TO INSURANCE

Memo

BILL NUMBER:S6603

TITLE OF BILL: An act to amend the insurance law, in relation to coverage for cervical cytology screening for insureds by certain corporations and insurance policies

PURPOSE OR GENERAL IDEA OF BILL: To update the 1993 law that provides coverage for cervical cancer screening in order to reflect current clinical guidelines related to testing frequency

SUMMARY OF SPECIFIC PROVISIONS: Section one provides that certain insurance policies provide reimbursement coverage for cervical cytology screening for cervical cancer and its precursor states on a schedule that is consistent with the guidelines established by the American College of Obstetricians and the Gynecologists (ACOG) and the American Cancer Society (ACS). Women with certain risk factors, who may need more frequent screening in the reasonable medical judgment of their attending health care professional, shall be screened at a frequency that is determined by such health care professional.

Section two provides that every group or blanket policy which provides surgical or medical coverage shall provide coverage for cervical cytology screening for cervical cancer and its precursor states on a schedule that is consistent with the guidelines established by the American college of Obstetricians and the Gynecologists (ACOG) and the American Cancer Society (ACS). Women with certain risk factors, who may need more frequent screening in the reasonable medical judgment of their attending health care professional, shall be screened at a frequency that is determined by such health care professional.

Section three provides that a medical expense indemnity corporation, a hospital service corporation or a health service corporation which provides coverage for hospital, surgical, or medical care shall provide coverage for cervical cytology screening for cervical cancer and its precursor states on a schedule that is consistent with the guidelines established by the American College of Obstetricians and the Gynecologists (ACOG) and the American Cancer Society (ACS). Women with certain risk factors, who may need more frequent screening in the reasonable medical judgment of their attending health care professional, shall be screened at a frequency that is determined by such health care professional.

Section four provides the effective date.

JUSTIFICATION: The current law applying to insurance coverage for cervical cytology screening no longer reflects the most current evidence-based clinical guidelines for routine cervical cytology screening methods and frequency. In order to prevent cervical cancer and detect a human papiloma viral (HPV) infection, this legislation updates the law by providing that physicians utilize updated testing methods at a frequency that is in accordance with the most recent evidence-based

clinical guidelines. By adhering to such guidelines, it will also ensure that physicians are adequately reimbursed.

PRIOR LEGISLATIVE HISTORY: 2009-10: A.6458 - Referred to Insurance

FISCAL IMPLICATION: None to the state. Insurance companies already provide reimbursement for cervical cytology screening under current law. This legislation would help streamline testing frequency and prohibit outdated and unnecessary testing methods, thereby decreasing potential costs.

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


Text

STATE OF NEW YORK ________________________________________________________________________ 6603 IN SENATE March 2, 2012 ___________
Introduced by Sen. STAVISKY -- 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 cervical cytology screening for insureds by certain corporations and insurance policies THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subparagraph (A) of paragraph 15 of subsection (i) of section 3216 of the insurance law, as amended by chapter 219 of the laws of 2011, is amended to read as follows: (A) Every policy that provides hospital, surgical or medical care coverage or provides reimbursement for laboratory tests or reimbursement for diagnostic X-ray services shall provide coverage for [an annual] cervical cytology screening for cervical cancer and its precursor states [for women aged eighteen and older] ACCORDING TO THE FOLLOWING: (I) FOR WOMEN YOUNGER THAN THIRTY YEARS, AT LEAST ONCE EVERY TWO YEARS; (II) FOR WOMEN AGED THIRTY YEARS AND OLDER WHO HAVE HAD THREE CONSECUTIVE CERVI- CAL CYTOLOGY TEST RESULTS THAT ARE SATISFACTORY AND NEGATIVE FOR INTRAEPITHELIAL LESIONS AND MALIGNANCY, AT LEAST ONCE EVERY THREE YEARS; AND (III) FOR OTHER WOMEN AGED THIRTY YEARS AND OLDER, AND FOR WOMEN WITH RISK FACTORS THAT REQUIRE MORE FREQUENT SCREENING IN THE REASONABLE MEDICAL JUDGMENT OF THEIR ATTENDING HEALTH CARE PROFESSIONAL, AS DETER- MINED BY THAT HEALTH CARE PROFESSIONAL. S 2. Subparagraph (A) of paragraph 14 of subsection (l) of section 3221 of the insurance law, as amended by chapter 219 of the laws of 2011, is amended to read as follows: (A) Every group or blanket policy delivered or issued for delivery in this state that provides hospital, surgical or medical coverage shall provide coverage for [an annual] cervical cytology screening for cervi- cal cancer and its precursor states [for women aged eighteen and older] ACCORDING TO THE FOLLOWING: (I) FOR WOMEN YOUNGER THAN THIRTY YEARS, AT LEAST ONCE EVERY TWO YEARS; (II) FOR WOMEN AGED THIRTY YEARS AND OLDER WHO HAVE HAD THREE CONSECUTIVE CERVICAL CYTOLOGY TEST RESULTS THAT ARE SATISFACTORY AND NEGATIVE FOR INTRAEPITHELIAL LESIONS AND MALIGNANCY, AT
LEAST ONCE EVERY THREE YEARS; AND (III) FOR OTHER WOMEN AGED THIRTY YEARS AND OLDER, AND FOR WOMEN WITH RISK FACTORS THAT REQUIRE MORE FREQUENT SCREENING IN THE REASONABLE MEDICAL JUDGMENT OF THEIR ATTENDING HEALTH CARE PROFESSIONAL, AS DETERMINED BY THAT HEALTH CARE PROFESSIONAL. S 3. Paragraph 1 of subsection (t) of section 4303 of the insurance law, as amended by chapter 219 of the laws of 2011, is amended to read as follows: (1) A medical expense indemnity corporation, a hospital service corpo- ration or a health service corporation that provides coverage for hospi- tal, surgical, or medical care shall provide coverage for [an annual] cervical cytology screening for cervical cancer and its precursor states ACCORDING TO THE FOLLOWING: (I) for women [aged eighteen and older] YOUNGER THAN THIRTY YEARS, AT LEAST ONCE EVERY TWO YEARS; (II) FOR WOMEN AGED THIRTY YEARS OR OLDER WHO HAVE HAD THREE CONSECUTIVE CERVICAL CYTOLOGY TEST RESULTS THAT ARE SATISFACTORY AND NEGATIVE FOR INTRAEP- ITHELIAL LESIONS AND MALIGNANCY AT LEAST ONCE EVERY THREE YEARS; AND (III) FOR OTHER WOMEN AGED THIRTY YEARS AND OLDER, AND FOR WOMEN WITH RISK FACTORS THAT REQUIRE MORE FREQUENT SCREENING IN THE REASONABLE MEDICAL JUDGMENT OF THEIR ATTENDING HEALTH CARE PROFESSIONAL, AS DETER- MINED BY THAT HEALTH CARE PROFESSIONAL. Such coverage required by this paragraph 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 contract. S 4. This act shall take effect on the first of January next succeed- ing the date on which it shall have become law and shall apply to all policies issued, renewed, modified or altered on or after such date.

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