STATE OF NEW YORK ________________________________________________________________________ 4811 2023-2024 Regular Sessions IN ASSEMBLY February 23, 2023 ___________ Introduced by M. of A. PRETLOW -- read once and referred to the Commit- tee on Insurance AN ACT to amend the insurance law, in relation to requiring coverage for genetic testing in accident and health insurance policies The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Section 3216 of the insurance law is amended by adding a 2 new subsection (n) to read as follows: 3 (n) (1) (A) For purposes of this subsection: "Predisposing genetic 4 characteristic" shall mean any inherited gene or chromosome, or alter- 5 ation thereof, and determined by a genetic test or inferred from infor- 6 mation derived from an individual or family member that is scientif- 7 ically or medically believed to predispose an individual or the 8 offspring of that individual to a disease or disability, or to be asso- 9 ciated with a statistically significant increased risk of the develop- 10 ment of a physical or mental disease or disability; and 11 (B) "Genetic testing" shall mean a test for determining the presence 12 or absence of an inherited genetic characteristic in an individual, 13 including tests of nucleic acids such as DNA, RNA and mitochondrial DNA, 14 chromosomes or proteins in order to identify a predisposing genetic 15 characteristic. 16 (2) On and after September first, two thousand twenty-three every 17 policy delivered or issued for delivery in this state which provides 18 medical coverage that includes coverage for physician services in a 19 physician's office and every policy which provides major medical or 20 similar comprehensive-type coverage shall provide coverage for genetic 21 testing, and any subsequent treatment resulting from the results of such 22 test, of persons who, in the opinion of an attending physician are 23 persons with a significant risk of contracting cancer. For purposes of 24 this section, a person shall be deemed to have a significant risk if 25 there is a family history of cancer, more than one generation in such EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09444-01-3
A. 4811 2 1 family has had cancer, a family member has had more than one occurrence 2 of cancer or a family member less than forty-five years of age has been 3 diagnosed with cancer. Nothing in this subsection shall be deemed to 4 authorize an insurer to utilize or release the results of such test for 5 any other purpose. No policy delivered or issued for delivery in this 6 state pursuant to this article, shall be denied or cancelled on the 7 basis of a predisposing genetic characteristic. 8 § 2. Subsection (l) of section 3221 of the insurance law is amended by 9 adding a new paragraph 11-c to read as follows: 10 (11-c) (A) (i) For purposes of this paragraph: "Predisposing genetic 11 characteristic" shall mean any inherited gene or chromosome, or alter- 12 ation thereof, and determined by a genetic test or inferred from infor- 13 mation derived from an individual or family member that is scientif- 14 ically or medically believed to predispose an individual or the 15 offspring of that individual to a disease or disability, or to be asso- 16 ciated with a statistically significant increased risk of the develop- 17 ment of a physical or mental disease or disability; and 18 (ii) "Genetic testing" shall mean a test for determining the presence 19 or absence of an inherited genetic characteristic in an individual, 20 including tests of nucleic acids such as DNA, RNA and mitochondrial DNA, 21 chromosomes or proteins in order to identify a predisposing genetic 22 characteristic. 23 (B) On and after September first, two thousand twenty-three every 24 policy delivered or issued for delivery in this state which provides 25 medical coverage that includes coverage for physician services in a 26 physician's office and major medical or similar comprehensive-type 27 coverage shall provide coverage for genetic testing, and any subsequent 28 treatment resulting from the results of such test, of persons who, in 29 the opinion of an attending physician are persons with a significant 30 risk of contracting cancer. For purposes of this section, a person shall 31 be deemed to have a significant risk if there is a family history of 32 cancer, more than one generation in such family has had cancer, a family 33 member has had more than one occurrence of cancer or a family member 34 less than forty-five years of age has been diagnosed with cancer. Noth- 35 ing in this paragraph shall be deemed to authorize an insurer to utilize 36 or release the results of such test for any other purpose. No policy 37 delivered or issued for delivery in this state pursuant to this article, 38 shall be denied or cancelled on the basis of a predisposing genetic 39 characteristic. 40 § 3. Section 4303 of the insurance law is amended by adding a new 41 subsection (uu) to read as follows: 42 (uu) (1) (A) For purposes of this subsection: "Predisposing genetic 43 characteristic" shall mean any inherited gene or chromosome, or alter- 44 ation thereof, and determined by a genetic test or inferred from infor- 45 mation derived from an individual or family member that is scientif- 46 ically or medically believed to predispose an individual or the 47 offspring of that individual to a disease or disability, or to be asso- 48 ciated with a statistically significant increased risk of the develop- 49 ment of a physical or mental disease or disability; and 50 (B) "Genetic testing" shall mean a test for determining the presence 51 or absence of an inherited genetic characteristic in an individual, 52 including tests of nucleic acids such as DNA, RNA and mitochondrial DNA, 53 chromosomes or proteins in order to identify a predisposing genetic 54 characteristic. 55 (2) On and after September first, two thousand twenty-three every 56 policy delivered or issued for delivery in this state which provides
A. 4811 3 1 medical coverage that includes coverage for physician services in a 2 physician's office or major medical or similar comprehensive-type cover- 3 age shall provide coverage for genetic testing, and any subsequent 4 treatment resulting from the results of such test, of persons who, in 5 the opinion of an attending physician are persons with a significant 6 risk of contracting cancer. For purposes of this section, a person shall 7 be deemed to have a significant risk if there is a family history of 8 cancer, more than one generation in such family has had cancer, a family 9 member has had more than one occurrence of cancer or a family member 10 less than forty-five years of age has been diagnosed with cancer. Noth- 11 ing in this subsection shall be deemed to authorize an insurer to 12 utilize or release the results of such test for any other purpose. No 13 policy delivered or issued for delivery in this state pursuant to this 14 article, shall be denied or cancelled on the basis of a predisposing 15 genetic characteristic. 16 § 4. This act shall take effect immediately.