Requires coverage for colorectal cancer early detection beginning at age thirty-five; adds coverage for colorectal cancer early detection as a required coverage for individual policies; requires notification of colorectal early detection coverage to be provided to insured individuals beginning at age thirty-five.
Summary
This bill would amend New York insurance law to require health insurance coverage for colorectal cancer preventive screenings beginning at age 35, rather than under the current age threshold reflected in the American Cancer Society guidelines. It applies to large group policies and contracts, individual policies, and related comprehensive medical coverage, and it requires coverage for screenings, examinations, laboratory tests, an initial colonoscopy or other screening test, and a follow-up colonoscopy when a non-colonoscopy test is positive.
The bill also bars deductibles, coinsurance, and other cost-sharing for covered colorectal cancer screening services when provided by participating providers. In addition, it requires insurers, health maintenance organizations, and related carriers to notify insureds and enrollees age 35 and older at least annually about covered colorectal cancer screenings and the most recent American Cancer Society screening guidelines. The measure would take effect immediately and apply to policies issued, delivered, renewed, or modified on or after the effective date.
Impact
The bill would expand mandated health insurance benefits in New York by lowering the age at which colorectal cancer screening coverage must begin and by extending those requirements across large group, individual, and other comprehensive health plans. It would amend multiple sections of the Insurance Law, including provisions governing large group policies, large group contracts, individual policies, and insurer notification requirements, thereby creating a uniform statewide coverage standard for colorectal cancer early detection starting at age 35.
Sentiment
No committee transcript or vote record was provided, so there is no direct evidence of debate or recorded support/opposition in the materials supplied. Based on the bill text, the measure appears to be framed as a preventive health coverage expansion aimed at earlier detection and reduced out-of-pocket costs, which typically suggests a public-health-oriented and consumer-protection rationale.
Contention
The main policy issue is the lowered screening age threshold, which may be supported by advocates for earlier cancer detection but could raise concerns among insurers and other payers about increased utilization and premium impact. Another possible point of contention is the mandate to cover screenings without cost-sharing, which shifts more costs to insurers and may be viewed as beneficial to patients but financially burdensome by carriers. The annual notice requirement and the inclusion of follow-up colonoscopies after non-colonoscopy tests may also be discussed as administrative and cost implications for plans.
Same As
Requires coverage for colorectal cancer early detection beginning at age thirty-five; adds coverage for colorectal cancer early detection as a required coverage for individual policies; requires notification of colorectal early detection coverage to be provided to insured individuals beginning at age thirty-five.
Requires coverage for colorectal cancer early detection beginning at age thirty-five; adds coverage for colorectal cancer early detection as a required coverage for individual policies; requires notification of colorectal early detection coverage to be provided to insured individuals beginning at age thirty-five.
Coverage for certain diagnostic and screening colorectal cancer tests required, early colorectal cancer screening required, and education program developed.
To enact sections 3902.65 and 5164.081 of the Revised Code to require insurance and Medicaid coverage of colorectal cancer screenings for individuals age 21 and older.
Medicaid Agency, colorectal cancer screening test, coverage required for test based on grade A or B recommendation from U.S. Preventative Services Task Force
Medicaid Agency, colorectal cancer screening test, coverage required for test based on grade A or B recommendation from U.S. Preventative Services Task Force