BILL NUMBER: S7987A
SPONSOR: MAYER
 
TITLE OF BILL:
An act to amend the insurance law and the public health law, in relation
to ensuring continuity of care for cancer patients during insurance
contract negotiations
 
PURPOSE:
This legislation will ensure that oncology patients currently being
treated for cancer will continue to receive coverage from their insurers
in the event that the insurer and oncology treatment provider fail to
agree during contract renewal negotiations. In such an event, all such
patients will be "grandfathered" under the insurer and oncology treat-
ment provider, and will remain covered by insurance and treated by such
provider, for the balance of the course of their treatment.
 
SUMMARY OF SPECIFIC PROVISIONS:
Section 1 sets forth that this act shall be know and may be cited as the
"Continuity of Cancer Care Act" or the "COCCA".
Section 2 amends Section 3216 of the insurance law by adding language
stating insurers must continue covering care for such treatments,
regardless of contractual disputes, throughout the insured's course of
treatment. The bill defines course of treatment as the time period
during which the treatment protocol aimed at combatting the insured's
cancer has been fully administered and the insured is found to be clin-
ically stable. The course of treatment also covers any follow-up
appointments within 90 days of when the insured is clinically stable.
Additionally, the section provides that insurance companies must contin-
ue to cover treatments at the rate payable under the prior contract, and
that such rate will be adjusted at the beginning of the next calendar
year by the applicable Medicaid Economic Index minus one percentage
point.
Section 3 amends Section 3221 of the insurance law by adding language
stating insurers must continue covering care for such treatments,
regardless of contractual disputes, until the conclusion of the
insured's care.
Section 4 amends Section 4304 of the insurance law by adding language
stating insurers must continue covering care for such treatments,
regardless of contractual disputes, until the conclusion of the
insured's care.
Section 5 amends the Public Health Law by adding a new section 2404-e
entitled Cancer; duty to continue treatment - which states insurers must
continue covering care for such treatments, regardless of contractual
disputes, until the conclusion of the insured's care.
Section 6 sets the effective date.
 
JUSTIFICATION:
Dealing with a diagnosis of cancer is difficult enough for both the
patient and their loved ones. For a patient to thereafter receive a
letter from their insurance provider, that their oncologists may no
longer be considered "in network" with such insurance provider, is
simply too much to bear. Nonetheless, in October 2024, a major insurer
provider sent such a letter to tens of thousands of its insured
patients, regarding their contract negotiations with Memorial Sloan
Kettering Cancer Center ("MSKCC"), stating that coverage for any and all
treatments would end December 31, 2024. Soon thereafter, the insurance
provider sent a follow-up letter stating they would "grandfather" all
patients, currently under treatment, until March 31, 2025. Thankfully,
the parties came to an agreement. Had they not, thousands of cancer
patients would have been forced to leave MSKCC in April 2025, regardless
of the status of their treatment. This bill ensures that any patients
currently under treatment, will be automatically grandfathered for
continued care until the end of their treatment.
 
PRIOR LEGISLATIVE HISTORY:
New bill.
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
This act shall take effect immediately.

Statutes affected:
S7987: 3216 insurance law, 3221 insurance law, 4303 insurance law
S7987A: 3216 insurance law, 3221 insurance law, 4303 insurance law