Shown verbatim: the complete text as captured from the official source posted by the New York State Senate, fetched 2026-08-11. Nothing is edited or removed. Where this bill amends existing law, language marked for deletion in the official source appears here in brackets. The official bill page.
S T A T E O F N E W Y O R K
________________________________________________________________________
1195--A
2025-2026 Regular Sessions
I N A S S E M B L Y
January 9, 2025
___________
Introduced by M. of A. PEOPLES-STOKES, WEPRIN, REYES, SHIMSKY, SIMON,
HEVESI, LUNSFORD, CRUZ, MEEKS, STECK, RAGA, LUPARDO, BUTTENSCHON,
O'PHARROW, SIMONE, BURDICK, ZACCARO, LAVINE, BRONSON, EPSTEIN, STIRPE,
SANTABARBARA, MAHER, SLATER -- read once and referred 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 mandatory health
insurance coverage for follow-up screening or diagnostic services for
lung 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 41 to read as follows:
(41) (A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMI-
LAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR FOLLOW-UP
SCREENING OR DIAGNOSTIC SERVICES FOR LUNG CANCER UPON THE RECOMMENDATION
OF A HEALTH CARE PROVIDER ACTING WITHIN THE PROVIDER'S SCOPE OF PRACTICE
PURSUANT TO TITLE EIGHT OF THE EDUCATION LAW, AND AS RECOMMENDED BY
NATIONALLY RECOGNIZED CLINICAL PRACTICE GUIDELINES FOR THE DETECTION OF
LUNG CANCER.
(B) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ANY POLICY THAT
PROVIDES COVERAGE REQUIRED BY THIS PARAGRAPH SHALL NOT IMPOSE PATIENT
COST SHARING FOR FOLLOW-UP SCREENING OR DIAGNOSTIC SERVICES FOR LUNG
CANCER.
(C) FOR THE PURPOSES OF THIS PARAGRAPH, "NATIONALLY RECOGNIZED CLIN-
ICAL PRACTICE GUIDELINES" MEANS EVIDENCE-BASED, PEER REVIEWED CLINICAL
PRACTICE GUIDELINES INFORMED BY A SYSTEMATIC REVIEW OF EVIDENCE AND AN
ASSESSMENT OF THE BENEFITS, AND RISKS OF ALTERNATIVE CARE OPTIONS
INTENDED TO OPTIMIZE PATIENT CARE DEVELOPED BY INDEPENDENT ORGANIZATIONS
OR MEDICAL PROFESSIONAL SOCIETIES UTILIZING A TRANSPARENT METHODOLOGY
AND REPORTING STRUCTURE AND WITH A CONFLICT OF INTEREST POLICY.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02876-02-5
A. 1195--A 2
(D) NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO PREVENT MEDICAL
MANAGEMENT OR UTILIZATION REVIEW OF THE SERVICES, INCLUDING PREAUTHORI-
ZATION, TO ENSURE THAT SUCH SERVICES ARE CONSISTENT WITH NATIONALLY
RECOGNIZED CLINICAL PRACTICE GUIDELINES FOR THE DETECTION OF LUNG
CANCER.
(E) IF THE POLICY IS A HIGH DEDUCTIBLE HEALTH PLAN AS DEFINED IN
SECTION 223(C)(2) OF THE INTERNAL REVENUE CODE OF 1986, SUCH COVERAGE
MAY BE SUBJECT TO THE PLAN'S ANNUAL DEDUCTIBLE IF APPLICATION OF THIS
REQUIREMENT WOULD RESULT IN INELIGIBILITY FOR A HEALTH SAVINGS ACCOUNT.
§ 2. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 23 to read as follows:
(23) (A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMI-
LAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR FOLLOW-UP
SCREENING OR DIAGNOSTIC SERVICES FOR LUNG CANCER UPON THE RECOMMENDATION
OF A HEALTH CARE PROVIDER ACTING WITHIN THE PROVIDER'S SCOPE OF PRACTICE
PURSUANT TO TITLE EIGHT OF THE EDUCATION LAW, AND AS RECOMMENDED BY
NATIONALLY RECOGNIZED CLINICAL PRACTICE GUIDELINES FOR THE DETECTION OF
LUNG CANCER.
(B) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ANY POLICY THAT
PROVIDES COVERAGE REQUIRED BY THIS PARAGRAPH SHALL NOT IMPOSE PATIENT
COST SHARING FOR FOLLOW-UP SCREENING OR DIAGNOSTIC SERVICES FOR LUNG
CANCER.
(C) FOR THE PURPOSES OF THIS PARAGRAPH, "NATIONALLY RECOGNIZED CLIN-
ICAL PRACTICE GUIDELINES" MEANS EVIDENCE-BASED, PEER REVIEWED CLINICAL
PRACTICE GUIDELINES INFORMED BY A SYSTEMATIC REVIEW OF EVIDENCE AND AN
ASSESSMENT OF THE BENEFITS, AND RISKS OF ALTERNATIVE CARE OPTIONS
INTENDED TO OPTIMIZE PATIENT CARE DEVELOPED BY INDEPENDENT ORGANIZATIONS
OR MEDICAL PROFESSIONAL SOCIETIES UTILIZING A TRANSPARENT METHODOLOGY
AND REPORTING STRUCTURE AND WITH A CONFLICT OF INTEREST POLICY.
(D) NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO PREVENT MEDICAL
MANAGEMENT OR UTILIZATION REVIEW OF THE SERVICES, INCLUDING PREAUTHORI-
ZATION, TO ENSURE THAT SUCH SERVICES ARE CONSISTENT WITH NATIONALLY
RECOGNIZED CLINICAL PRACTICE GUIDELINES FOR THE DETECTION OF LUNG
CANCER.
(E) IF THE POLICY IS A HIGH DEDUCTIBLE HEALTH PLAN AS DEFINED IN
SECTION 223(C)(2) OF THE INTERNAL REVENUE CODE OF 1986, SUCH COVERAGE
MAY BE SUBJECT TO THE PLAN'S ANNUAL DEDUCTIBLE IF APPLICATION OF THIS
REQUIREMENT WOULD RESULT IN INELIGIBILITY FOR A HEALTH SAVINGS ACCOUNT.
§ 3. Section 4303 of the insurance law is amended by adding a new
subsection (ww) to read as follows:
(WW) (1) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMI-
LAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR FOLLOW-UP
SCREENING OR DIAGNOSTIC SERVICES FOR LUNG CANCER UPON THE RECOMMENDATION
OF A HEALTH CARE PROVIDER ACTING WITHIN THE PROVIDER'S SCOPE OF PRACTICE
PURSUANT TO TITLE EIGHT OF THE EDUCATION LAW, AND AS RECOMMENDED BY
NATIONALLY RECOGNIZED CLINICAL PRACTICE GUIDELINES FOR THE DETECTION OF
LUNG CANCER.
(2) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ANY POLICY THAT
PROVIDES COVERAGE REQUIRED BY THIS SUBSECTION SHALL NOT IMPOSE PATIENT
COST SHARING FOR FOLLOW-UP SCREENING OR DIAGNOSTIC SERVICES FOR LUNG
CANCER.
(3) FOR THE PURPOSES OF THIS PARAGRAPH, "NATIONALLY RECOGNIZED CLIN-
ICAL PRACTICE GUIDELINES" MEANS EVIDENCE-BASED, PEER REVIEWED CLINICAL
PRACTICE GUIDELINES INFORMED BY A SYSTEMATIC REVIEW OF EVIDENCE AND AN
ASSESSMENT OF THE BENEFITS, AND RISKS OF ALTERNATIVE CARE OPTIONS
INTENDED TO OPTIMIZE PATIENT CARE DEVELOPED BY INDEPENDENT ORGANIZATIONS
A. 1195--A 3
OR MEDICAL PROFESSIONAL SOCIETIES UTILIZING A TRANSPARENT METHODOLOGY
AND REPORTING STRUCTURE AND WITH A CONFLICT OF INTEREST POLICY.
(4) NOTHING IN THIS PARAGRAPH SHALL BE CONSTRUED TO PREVENT MEDICAL
MANAGEMENT OR UTILIZATION REVIEW OF THE SERVICES, INCLUDING PREAUTHORI-
ZATION, TO ENSURE THAT SUCH SERVICES ARE CONSISTENT WITH NATIONALLY
RECOGNIZED CLINICAL PRACTICE GUIDELINES FOR THE DETECTION OF LUNG
CANCER.
(5) IF THE POLICY IS A HIGH DEDUCTIBLE HEALTH PLAN AS DEFINED IN
SECTION 223(C)(2) OF THE INTERNAL REVENUE CODE OF 1986, SUCH COVERAGE
MAY BE SUBJECT TO THE PLAN'S ANNUAL DEDUCTIBLE IF APPLICATION OF THIS
REQUIREMENT WOULD RESULT IN INELIGIBILITY FOR A HEALTH SAVINGS ACCOUNT.
§ 4. This act shall take effect January 1, 2027 and shall apply to all
policies and contracts issued, renewed, modified, altered or amended on
or after such date.Every fact on this page links to its source, starting with the official bill record.