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Petitions for change  -- PROPOSED lEGISLATION

STATE OF NEW YORK ________________________________________________________________________ 984 2019-2020 Regular Sessions IN SENATE January 9, 2019 ___________ Introduced by Sen. BRESLIN -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law, in relation to requiring dihydro- pyrimidine dehydrogenase deficiency testing for certain individuals with cancer; to amend the insurance law, in relation to requiring policies and contracts of insurance to include coverage for dihydropy- rimidine dehydrogenase deficiency testing; and to amend the social services law, in relation to the provision of dihydropyrimidine dehyd- rogenase deficiency testing under the medical assistance programThe People of the State of New York, represented in Senate and Assem-bly, do enact as follows: 1 Section 1. The public health law is amended by adding a new section 2 2400-a to read as follows: 3 § 2400-a. Dihydropyrimidine dehydrogenase deficiency testing. 1. For 4 purposes of this section the following terms shall have the following 5 meanings: 6 (a) "Antimetabolites" means a substance that interferes with the 7 normal metabolic processes within cells, typically by combining with 8 enzymes. 9 (b) "Dihydropyrimidine dehydrogenase deficiency" means a condition in 10 which the body cannot break down the nucleotides thymine and uracil. 11 (c) "Fluoropyrmidine" means a group of substances used to treat cancer 12 through chemotherapy. 13 2. Every physician or other authorized practitioner who provides fluo- 14 ropyrmidine or other antimetabolites to individuals diagnosed with 15 cancer shall test for dihydropyrimidine dehydrogenase deficiency prior 16 to such treatment. 17 § 2. Subparagraph (A) of paragraph 12-a of subsection (i) of section 18 3216 of the insurance law, as amended by chapter 12 of the laws of 2012, 19 is amended to read as follows: EXPLANATION--Matter in (underscored) is new; matter in bracketsitalics [] is old law to be omitted. LBD02330-01-9 S. 984 2 1 (A) Every policy delivered or issued for delivery in this state that 2 provides medical, major medical, or similar comprehensive-type coverage 3 and provides coverage for prescription drugs and also provides coverage 4 for cancer chemotherapy treatment shall provide coverage for prescribed, 5 orally administered anticancer medications used to kill or slow the 6 growth of cancerous cells, and shall provide coverage for dihydropyrimi- 7 dine dehydrogenase deficiency testing prior to such treatment where such 8 . Suchtreatment consists of fluoropyrmidine or other antimetabolites 9 coverage may be subject to co-pays, coinsurance or deductibles, provided 10 that the co-pays, coinsurance or deductibles are at least as favorable 11 to an insured as the co-pays, coinsurance or deductibles that apply to 12 coverage for intravenous or injected anticancer medications. 13 § 3. Subparagraph (A) of paragraph 12-a of subsection (l) of section 14 3221 of the insurance law, as amended by chapter 12 of the laws of 2012, 15 is amended to read as follows: 16 (A) Every policy delivered or issued for delivery in this state that 17 provides medical, major medical, or similar comprehensive-type coverage 18 and provides coverage for prescription drugs and also provides coverage 19 for cancer chemotherapy treatment shall provide coverage for prescribed, 20 orally administered anticancer medications used to kill or slow the 21 growth of cancerous cells, and shall provide coverage for dihydropyrimi- 22 dine dehydrogenase deficiency testing prior to such treatment where such 23 . Suchtreatment consists of fluoropyrmidine or other antimetabolites 24 coverage may be subject to co-pays, coinsurance or deductibles, provided 25 that the co-pays, coinsurance or deductibles are at least as favorable 26 to an insured as the co-pays, coinsurance or deductibles that apply to 27 coverage for intravenous or injected anticancer medications. 28 § 4. Paragraph 1 of subsection (q-1) of section 4303 of the insurance 29 law, as amended by chapter 12 of the laws of 2012, is amended to read as 30 follows: 31 (1) Every contract issued by a medical expense indemnity corporation, 32 a hospital service corporation or a health service corporation for 33 delivery in this state that provides medical, major medical or similar 34 comprehensive-type coverage and provides coverage for prescription drugs 35 and for cancer chemotherapy treatment shall provide coverage for 36 prescribed, orally administered anticancer medications used to kill or 37 slow the growth of cancerous cells, and shall provide coverage for dihy- 38 dropyrimidine dehydrogenase deficiency testing prior to such treatment 39 where such treatment consists of fluoropyrmidine or other antimetabol- 40 . Such coverage may be subject to co-pays, coinsurance or deduct-ites 41 ibles, provided that the co-pays, coinsurance or deductibles are at 42 least as favorable to an insured as the co-pays, coinsurance or deduct- 43 ibles that apply to coverage for intravenous or injected anticancer 44 medications. 45 § 5. The social services law is amended by adding a new section 365-o 46 to read as follows: 47 § 365-o. Provision of dihydropyrimidine dehydrogenase deficiency test- 48 ing. 1. The commissioner shall establish standards and guidelines for 49 the provision of dihydropyrimidine dehydrogenase deficiency testing 50 prior to cancer treatment through fluoropyrmidine or other antimetabol- 51 ites under the medical assistance program. 52 2. For purposes of this section: 53 (a) "Antimetabolites" means a substance that interferes with the 54 normal metabolic processes within cells, typically by combining with 55 enzymes. S. 984 3 1 (b) "Dihydropyrimidine dehydrogenase deficiency" means a condition in 2 which the body cannot break down the nucleotides thymine and uracil. 3 (c) "Fluoropyrmidine" means a group of substances used to treat cancer 4 through chemotherapy. 5 § 6. This act shall take effect on the one hundred twentieth day after 6 it shall have become a law. Effective immediately, the addition, amend- 7 ment and/or repeal of any rule or regulation necessary for the implemen- 8 tation of this act on its effective date are authorized to be made and 9 completed on or before such effective date.