Bill S6894A-2009

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

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

Details

Actions

  • Jun 9, 2010: ADVANCED TO THIRD READING
  • Jun 8, 2010: 2ND REPORT CAL.
  • Jun 7, 2010: 1ST REPORT CAL.752
  • May 24, 2010: PRINT NUMBER 6894A
  • May 24, 2010: AMEND AND RECOMMIT TO INSURANCE
  • Feb 23, 2010: REFERRED TO INSURANCE

Votes

VOTE: COMMITTEE VOTE: - Insurance - Jun 7, 2010
Ayes (10): Breslin, Stachowski, Kruger, Diaz, Parker, Sampson, Thompson, Johnson C, Espada, Peralta
Ayes W/R (5): LaValle, Alesi, Golden, Young, McDonald
Nays (3): Seward, Larkin, Leibell

Memo

 BILL NUMBER:  S6894A

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 27 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 or certified nurse practitioner.

Section 2 amends subsection (1) of section 3221 of the insurance law by adding a new paragraph 18 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 or certified nurse practitioner.

Section 3 amends section 4303 of the insurance law by adding a new subsection (gg) 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 or certified nurse practitioner.

Section 4. 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, it's 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 : New Bill.

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.

Text

STATE OF NEW YORK ________________________________________________________________________ 6894--A IN SENATE February 23, 2010 ___________
Introduced by Sens. C. JOHNSON, SAVINO -- read twice and ordered print- ed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee 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 27 to read as follows: (27) (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 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 18 to read as follows: (18) (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. (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 (gg) to read as follows: (GG)(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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