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A02198 Summary:

BILL NOA02198
 
SAME ASSAME AS S00824
 
SPONSORDinowitz
 
COSPNSR
 
MLTSPNSR
 
Rpld §3216 sub§ (i) ¶11-b, amd §§3221 & 4303, add §339, Ins L; rpld §3, amd §4, Chap of 2022 (as proposed in S.906-B & A.2085-A)
 
Makes technical amendments to chapter requiring insurance coverage for colorectal cancer screenings.
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A02198 Actions:

BILL NOA02198
 
01/23/2023referred to insurance
01/31/2023reported referred to rules
01/31/2023reported
01/31/2023rules report cal.68
01/31/2023ordered to third reading rules cal.68
02/01/2023substituted by s824
 S00824 AMEND= SANDERS
 01/06/2023REFERRED TO RULES
 01/09/2023ORDERED TO THIRD READING CAL.33
 01/18/2023PASSED SENATE
 01/18/2023DELIVERED TO ASSEMBLY
 01/18/2023referred to insurance
 02/01/2023substituted for a2198
 02/01/2023ordered to third reading rules cal.68
 02/01/2023passed assembly
 02/01/2023returned to senate
 03/03/2023DELIVERED TO GOVERNOR
 03/03/2023SIGNED CHAP.78
 01/06/2023REFERRED TO RULES
 01/09/2023ORDERED TO THIRD READING CAL.33
 01/18/2023PASSED SENATE
 01/18/2023DELIVERED TO ASSEMBLY
 01/18/2023referred to insurance
 02/01/2023substituted for a2198
 02/01/2023ordered to third reading rules cal.68
 02/01/2023passed assembly
 02/01/2023returned to senate
 03/03/2023DELIVERED TO GOVERNOR
 03/03/2023SIGNED CHAP.78
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A02198 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A2198
 
SPONSOR: Dinowitz
  TITLE OF BILL: An act to amend the insurance law and a chapter of the laws of 2022 relating to providing insurance coverage for colorectal cancer early detection, as proposed in legislative bills numbers S. 906-B and A. 2085-A, in relation to coverage for preventive screenings and notice requirements; and to repeal certain provisions of the insurance law and of such chapter relating thereto   PURPOSE OR GENERAL IDEA OF BILL: The purpose of this bill is to make amendments to Chapter 739 of the Laws of 2022 relating to providing insurance coverage for colorectal cancer early detection.   SUMMARY OF PROVISIONS: Sections 1-4 provide technical amendments to Chapter 739 of the Laws of 2022 and require large group health policies to provide coverage for colorectal cancer preventative screenings in accordance with American Cancer Society Guidelines. Section 5 provides that the Superintendent shall require insurers to notify insureds at least annually of colorectal cancer screenings cover by such insured's health insurance policy. Sections 6-7 make technical changes to the effective date.   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 meth- ods. By requiring coverage for preventative screenings, this deadly cancer can be detected earlier, making treatment more likely to be successful. Chapter 739 of the Laws of 2022 required health insurance providers to provide coverage for colorectal cancer screenings in accordance with the American Cancer Society guidelines for average risk individuals. As of May 2021, the guidelines recommend beginning screening at age 45 for such individuals. The Affordable Care Act (ACA) requires all private insurers (except "grandfathered" plans) and Medicaid expansion states to cover, without cost sharing, preventive services that receive an A or B rating from the United States Preventive Services Task Force (USPSTF). This Chapter Amendment provides that large group policies shall provide coverage for colorectal cancer screenings in accordance with the Ameri- can Cancer Society Guidelines for colorectal cancer screening of average risk individuals.   PRIOR LEGISLATIVE HISTORY: This is a new bill.   FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: None noted.   EFFECTIVE DATE: This act shall take effect immediately; provided that sections one, two, three, four and five of this act shall take effect on the same date and in the same manner as of a chapter of the laws of 2022 relating to providing insurance coverage for colorectal cancer early detection, as proposed in legislative bills number S.906-B and A.2085-A, takes effect.
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A02198 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          2198
 
                               2023-2024 Regular Sessions
 
                   IN ASSEMBLY
 
                                    January 23, 2023
                                       ___________
 
        Introduced by M. of A. DINOWITZ -- read once and referred to the Commit-
          tee on Insurance
 
        AN  ACT  to  amend  the  insurance law and a chapter of the laws of 2022
          relating to providing insurance coverage for colorectal  cancer  early
          detection,  as  proposed  in legislative bills numbers S. 906-B and A.
          2085-A, in relation to coverage for preventive screenings  and  notice
          requirements;  and  to  repeal certain provisions of the insurance law
          and of such chapter relating thereto
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  Paragraph  11-b  of subsection (i) of section 3216 of the
     2  insurance law, as added by a chapter of the laws of  2022  amending  the
     3  insurance  law  relating to providing insurance  coverage for colorectal
     4  cancer early detection, as proposed in legislative bills numbers S.906-B
     5  and A. 2085-A, is REPEALED.
     6    § 2. Paragraph 11-b of subsection (l) of section 3221 of the insurance
     7  law,  as  added  by a chapter of the laws of 2022 amending the insurance
     8  law relating to providing insurance    coverage  for  colorectal  cancer
     9  early detection, as proposed in legislative bills numbers S.906-B and A.
    10  2085-A,  is amended to read as follows:
    11    (11-b)  (A)  Every large group policy delivered or issued for delivery
    12  in this state which provides medical coverage that includes coverage for
    13  physician services in a physician's office and every large group  policy
    14  which  provides  major  medical  or  similar comprehensive-type coverage
    15  shall provide, upon the prescription of a health care provider  [legally
    16  authorized  to  prescribe  under]  acting within the provider's scope of
    17  practice pursuant to title eight of  the  education  law,  coverage  for
    18  colorectal  cancer  [screening] preventive screenings in accordance with
    19  the American Cancer Society Guidelines for colorectal  cancer  screening
    20  of  average  risk  individuals.  The coverage required by this paragraph
    21  shall also include [preventive colorectal cancer screening] coverage for
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD04015-01-3

        A. 2198                             2
 
     1  all additional  colorectal  cancer  examinations  and  laboratory  tests
     2  recommended  in  accordance  with the American Cancer Society Guidelines
     3  for colorectal cancer screening of average risk  individuals,  including
     4  an initial colonoscopy or other medical test or procedure for colorectal
     5  cancer  screening and a follow-up colonoscopy performed as a result of a
     6  positive result on a non-colonoscopy preventive screening test. A  large
     7  group policy shall cover colorectal cancer screenings, examinations, and
     8  laboratory tests described in this paragraph upon any policy issuance or
     9  renewal that occurs six months after the date the guideline described in
    10  this paragraph is issued.
    11    (B)  An  [individual]  insured  shall  not be subject to a deductible,
    12  coinsurance,  or  any  other  cost-sharing  requirements  for   services
    13  consistent with subparagraph (A) of this paragraph received from partic-
    14  ipating providers.
    15    §  3.  Section  4303  of  the insurance law is amended by adding a new
    16  subsection (uu) to read as follows:
    17    (uu) (1) Every large group contract delivered or issued  for  delivery
    18  in this state which provides medical coverage that includes coverage for
    19  physician  services  in  a  physician's  office  and  every  large group
    20  contract which provides  major  medical  or  similar  comprehensive-type
    21  coverage  shall provide, upon the prescription of a health care provider
    22  acting within the provider's scope of practice pursuant to  title  eight
    23  of  the education law, coverage for colorectal cancer preventive screen-
    24  ings in accordance with the American Cancer Society Guidelines for colo-
    25  rectal cancer  screening  of  average  risk  individuals.  The  coverage
    26  required  by  this  subsection shall also include coverage for all addi-
    27  tional colorectal cancer examinations and laboratory  tests  recommended
    28  in accordance with the American Cancer Society Guidelines for colorectal
    29  cancer screening of average risk individuals, including an initial colo-
    30  noscopy or other medical test or procedure for colorectal cancer screen-
    31  ing  and  a  follow-up  colonoscopy  performed as a result of a positive
    32  result on a non-colonoscopy preventive screening  test.  A  large  group
    33  contract  shall  cover  colorectal  cancer screenings, examinations, and
    34  laboratory tests described in this subsection upon any contract issuance
    35  or renewal that occurs six months after the date the guideline described
    36  in this subsection is issued.
    37    (2) An enrollee shall not be subject to a deductible, coinsurance,  or
    38  any  other  cost-sharing requirements for services consistent with para-
    39  graph one of this subsection received from participating providers.
    40    § 4. Section 3 of a chapter of the laws of 2022 relating to  providing
    41  insurance coverage for colorectal cancer early detection, as proposed in
    42  legislative bills numbers S.906-B and A. 2085-A, is REPEALED.
    43    §  5. The insurance law is amended by adding a new section 339 to read
    44  as follows:
    45    § 339. Colorectal cancer screening  notification.  The  superintendent
    46  shall  require an insurer authorized to write accident and health insur-
    47  ance in this state, a corporation organized pursuant to  article  forty-
    48  three  of  this chapter, and a health maintenance organization certified
    49  pursuant to article forty-four  of  the  public  health  law  to  notify
    50  insureds and enrollees at least annually of colorectal cancer screenings
    51  covered  by  such  insureds'  or  enrollees'  health insurance policy or
    52  contract, and of the most recently published guidelines of the  American
    53  Cancer Society for colorectal cancer screenings that are covered by such
    54  insureds'  or enrollees' health insurance policy or contract. The notice
    55  shall be delivered by United States postal mail unless  the  insured  or

        A. 2198                             3
 
     1  enrollee consents to another method of notification, including electron-
     2  ic notification.
     3    §  6. Section 4 of a chapter of the laws of 2022 relating to providing
     4  insurance coverage for colorectal cancer early detection, as proposed in
     5  legislative bills numbers S.906-B and A. 2085-A, is amended to  read  as
     6  follows:
     7    §  4.  This  act  shall take effect immediately and shall apply to any
     8  policy issued, [delivered,]  renewed,  [and/or]  modified,  altered,  or
     9  amended on or after the effective date of this act.
    10    §  7.  This  act shall take effect immediately; provided that sections
    11  one, two, three, four and five of this act shall take effect on the same
    12  date and in the same manner as of a chapter of the laws of 2022 relating
    13  to providing insurance coverage for colorectal cancer  early  detection,
    14  as  proposed  in  legislative bills numbers S.906-B and A. 2085-A, takes
    15  effect.
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