New York S 10480: Provides for mandatory health insurance coverage for coronary artery calcium diagnostic testing

Bill Text

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S10480 Summary:

BILL NOS10480 

&nbsp

SAME ASNo Same As

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SPONSORSCARCELLA-SPANTON

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COSPNSR

&nbsp

MLTSPNSR

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Amd §§3216, 3221 & 4303, Ins L

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Provides for mandatory health insurance coverage for coronary artery calcium diagnostic testing upon the recommendation of a health care provider; makes related provisions.

Go to top S10480 Actions:

BILL NOS10480 

&nbsp

05/15/2026REFERRED TO INSURANCE

Go to topS10480 Committee&nbspVotes:

Go to topS10480 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topS10480 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 10480

 IN SENATE

 May 15, 2026
 ___________

 Introduced by Sen. SCARCELLA-SPANTON -- read twice and ordered printed,
 and when printed to be committed to the Committee on Insurance

 AN ACT to amend the insurance law, in relation to mandatory health
 insurance coverage for coronary artery calcium diagnostic testing

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Subsection (i) of section 3216 of the insurance law is
 2 amended by adding a new paragraph 42 to read as follows:
 3 (42) (A) Every policy which provides medical, major medical, or simi-
 4 lar comprehensive-type coverage shall provide coverage for coronary
 5 artery calcium diagnostic testing upon the recommendation of a health
 6 care provider acting within such provider's scope of practice pursuant
 7 to title eight of the education law, and as recommended by nationally
 8 recognized clinical practice guidelines for the prevention of cardiovas-
 9 cular disease.
 10 (B) Notwithstanding any other provision of law, any policy that
 11 provides coverage required by this paragraph shall not impose patient
 12 cost sharing for coronary artery calcium diagnostic testing.
 13 (C) For the purposes of this paragraph, the term "nationally recog-
 14 nized clinical practice guidelines" shall mean evidence-based, peer
 15 reviewed clinical practice guidelines informed by a systematic review of
 16 evidence and an assessment of the benefits, and risks of alternative
 17 care options intended to optimize patient care developed by independent
 18 organizations or medical professional societies utilizing a transparent
 19 methodology and reporting structure and with a conflict of interest
 20 policy.
 21 (D) Nothing in this paragraph shall be construed to prevent medical
 22 management or utilization review of the services, including preauthori-
 23 zation, to ensure that such services are consistent with nationally
 24 recognized clinical practice guidelines for the prevention of cardiovas-
 25 cular disease.
 26 (E) If the policy is a high deductible health plan as defined in
 27 section 223(c)(2) of the Internal Revenue Code of 1986, such coverage

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD15931-01-6

 S. 10480 2

 1 may be subject to the plan's annual deductible if application of this
 2 requirement would result in ineligibility for a health savings account.
 3 § 2. Subsection (l) of section 3221 of the insurance law is amended by
 4 adding a new paragraph 24 to read as follows:
 5 (24) (A) Every policy which provides medical, major medical, or simi-
 6 lar comprehensive-type coverage shall provide coverage for coronary
 7 artery calcium diagnostic testing upon the recommendation of a health
 8 care provider acting within such provider's scope of practice pursuant
 9 to title eight of the education law, and as recommended by nationally
 10 recognized clinical practice guidelines for the prevention of cardiovas-
 11 cular disease.
 12 (B) Notwithstanding any other provision of law, any policy that
 13 provides coverage required by this paragraph shall not impose patient
 14 cost sharing for coronary artery calcium diagnostic testing.
 15 (C) For the purposes of this paragraph, the term "nationally recog-
 16 nized clinical practice guidelines" shall mean evidence-based, peer
 17 reviewed clinical practice guidelines informed by a systematic review of
 18 evidence and an assessment of the benefits, and risks of alternative
 19 care options intended to optimize patient care developed by independent
 20 o