senate Bill S1883A

Requires health insurance policies to cover comprehensive ultrasound screening and magnetic resonance imaging for breast cancer in certain cases

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 13 / Jan / 2011
    • REFERRED TO INSURANCE
  • 11 / Feb / 2011
    • AMEND (T) AND RECOMMIT TO INSURANCE
  • 11 / Feb / 2011
    • PRINT NUMBER 1883A
  • 20 / Jun / 2011
    • COMMITTEE DISCHARGED AND COMMITTED TO RULES
  • 20 / Jun / 2011
    • ORDERED TO THIRD READING CAL.1419
  • 22 / Jun / 2011
    • PASSED SENATE
  • 22 / Jun / 2011
    • DELIVERED TO ASSEMBLY
  • 22 / Jun / 2011
    • REFERRED TO INSURANCE
  • 04 / Jan / 2012
    • DIED IN ASSEMBLY
  • 04 / Jan / 2012
    • RETURNED TO SENATE
  • 04 / Jan / 2012
    • REFERRED TO INSURANCE
  • 27 / Mar / 2012
    • RECOMMIT, ENACTING CLAUSE STRICKEN

Summary

Requires individual and group health insurance policies, and health maintenance organizations to provide coverage for comprehensive ultrasound screening, magnetic resonance imaging and/or other screening tests for breast cancer in certain cases; requires mammography reports to include information about breast density.

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Bill Details

Versions:
S1883
S1883A
Legislative Cycle:
2011-2012
Current Committee:
Senate Insurance
Law Section:
Insurance Law
Laws Affected:
Amd ยงยง3216, 3221, 4303 & 4326, Ins L
Versions Introduced in 2009-2010 Legislative Cycle:
S8488

Sponsor Memo

BILL NUMBER:S1883A

TITLE OF BILL:
An act
to amend the insurance law, in relation to requiring health insurance
policies to cover comprehensive ultrasound screening,
magnetic resonance imaging
and/or other screening tests
for breast cancer
in certain cases
and requiring the provision of certain information relating
to breast density to patients

PURPOSE:
This bill requires health insurance policies to provide additional
coverage supplementary screening tests of an entire breast or breasts
if a mammogram demonstrates dense breast tissue. It also requires
specific written notification to the patient of their breast density
and the availability of such additional tests.

SUMMARY OF PROVISIONS:
Section one amends paragraph 11 of subsection (i) of section 3216 of
the Insurance Law by adding a new subparagraph (D) which specifies
that insurance policies provide coverage for comprehensive ultrasound
screening, magnetic resonance imaging (MRI), and/or other screening
tests approved by the American College of Radiology if a mammogram
demonstrates dense breast tissue, or if a woman is believed to be at
increased risk for breast cancer due to family history, prior
personal history, positive genetic testing or other indications of
breast cancer.

This new section also requires that each mammography report provided
to a patient include information about their breast density and the
availability of supplemental screening tests for breast cancer.

In addition, it provides that such additional coverage may be subject
to annual deductibles and coinsurance as may be deemed appropriate by
the superintendent and as are consistent with those established for
other benefits within a given policy.

Section two amends paragraph 11 of subsection (1) of section 3221 of
the Insurance Law by adding a new subparagraph (D) to read exactly
the same as section one above.

Section three amends subsection (p) of section 4303 of the Insurance
Law by adding a new paragraph (4) to read exactly the same as section
one above.

Section four amends paragraph 7 of subsection (d) of section 4326 of
the Insurance Law, as added by chapter 1 of the laws of 1999 by
adding a cross reference to subsection (p) of section 4303 of the
Insurance Law.

Section five provides that this act shall take effect on the sixtieth
day after it shall have become a law.

EXISTING LAW:


Currently, the decision to refer a patient for a follow up ultrasound
screening or MRI subsequent to a mammogram which reveals dense breast
tissue is discretionary with the physician. Many times the patient is
not even aware of the fact that she has dense breast tissue.

JUSTIFICATION:
Breast cancer is the most frequently diagnosed cancer among women.
Cancer is five times more likely in women with dense breast tissue.

Mammograms can miss up to 40% of tumors present in dense breast tissue
as denser tissue tends to obscure tumors. Ultrasound screening, MRI
examinations, and/or other screening tests approved by the American
College of Radiology, after a mammography reveals dense breast tissue
can help doctors detect the presence of a tumor. Early detection is
key to the successful treatment of cancer.

Post mammogram written notification to patients with dense breast
tissue will keep patients informed. Raising awareness of breast
density is very important. Assisting physicians and patients in the
detection of early stage cancers serves to make them more treatable.

The State of Connecticut has already enacted this law. The States of
Florida, California, and Texas are in the process of considering it.

LEGISLATIVE HISTORY:
2010: S.8488 Rules

FISCAL IMPLICATIONS:
None.

LOCAL FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
This bill takes effect on the sixtieth day after it shall have become
a law.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 1883--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                            January 13, 2011
                               ___________

Introduced by Sens. FLANAGAN, BONACIC -- read twice and ordered printed,
  and  when  printed  to  be  committed 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 requiring health
  insurance  policies  to  cover  comprehensive  ultrasound   screening,
  magnetic  resonance  imaging  and/or  other screening tests for breast
  cancer in certain cases and requiring the provision of certain  infor-
  mation relating to breast density to patients

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Paragraph 11 of subsection  (i)  of  section  3216  of  the
insurance  law  is  amended  by adding a new subparagraph (D) to read as
follows:
  (D) (I) SUCH POLICY SHALL PROVIDE ADDITIONAL COVERAGE  FOR  COMPREHEN-
SIVE  ULTRASOUND  SCREENING,  MAGNETIC  RESONANCE  IMAGING (MRI), AND/OR
OTHER SCREENING TESTS APPROVED BY THE AMERICAN COLLEGE OF  RADIOLOGY  OF
AN ENTIRE BREAST OR THE ENTIRETY OF BOTH BREASTS IF:
  (I)  A  MAMMOGRAM  DEMONSTRATES  HETEROGENEOUS  OR DENSE BREAST TISSUE
BASED ON THE BREAST IMAGING REPORTING AND DATA SYSTEM ESTABLISHED BY THE
AMERICAN COLLEGE OF RADIOLOGY; OR
  (II) A WOMAN IS BELIEVED TO BE AT INCREASED RISK FOR BREAST CANCER DUE
TO FAMILY HISTORY OR PRIOR PERSONAL HISTORY OF BREAST  CANCER,  POSITIVE
GENETIC  TESTING  OR  OTHER  INDICATIONS  AS  DETERMINED BY SUCH WOMAN'S
PHYSICIAN OR NURSE PRACTITIONER.
  (II) SUCH ADDITIONAL COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND
COINSURANCE AS MAY BE DEEMED APPROPRIATE BY THE  SUPERINTENDENT  AND  AS
ARE  CONSISTENT WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A GIVEN
POLICY.
  (III) EACH MAMMOGRAPHY REPORT PROVIDED  TO  A  PATIENT  SHALL  INCLUDE
INFORMATION  ABOUT BREAST DENSITY, BASED ON THE BREAST IMAGING REPORTING

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00386-03-1

S. 1883--A                          2

AND DATA SYSTEM ESTABLISHED BY THE AMERICAN COLLEGE OF RADIOLOGY.  WHERE
APPLICABLE,  SUCH  REPORT  SHALL  INCLUDE THE FOLLOWING NOTICE: "IF YOUR
MAMMOGRAM DEMONSTRATES THAT YOU HAVE DENSE BREAST  TISSUE,  WHICH  COULD
HIDE SMALL ABNORMALITIES, YOU MIGHT BENEFIT FROM SUPPLEMENTARY SCREENING
TESTS,  DEPENDING ON YOUR INDIVIDUAL RISK FACTORS AND THE RECOMMENDATION
OF YOUR  INTERPRETING PHYSICIAN. A REPORT OF YOUR  MAMMOGRAPHY  RESULTS,
WHICH  CONTAINS  INFORMATION ABOUT YOUR BREAST DENSITY, HAS BEEN SENT TO
YOUR TREATING PHYSICIAN'S OFFICE AND YOU SHOULD  CONTACT  YOUR  TREATING
PHYSICIAN IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR REPORT."
  S  2.  Paragraph 11 of subsection (l) of section 3221 of the insurance
law is amended by adding a new subparagraph (D) to read as follows:
  (D) (I) SUCH POLICY SHALL PROVIDE ADDITIONAL COVERAGE  FOR  COMPREHEN-
SIVE  ULTRASOUND  SCREENING,  MAGNETIC  RESONANCE  IMAGING (MRI), AND/OR
OTHER SCREENING TESTS APPROVED BY THE AMERICAN COLLEGE OF  RADIOLOGY  OF
AN ENTIRE BREAST OR THE ENTIRETY OF BOTH BREASTS IF:
  (I)  A  MAMMOGRAM  DEMONSTRATES  HETEROGENEOUS  OR DENSE BREAST TISSUE
BASED ON THE BREAST IMAGING REPORTING AND DATA SYSTEM ESTABLISHED BY THE
AMERICAN COLLEGE OF RADIOLOGY; OR
  (II) A WOMAN IS BELIEVED TO BE AT AN INCREASED RISK FOR BREAST  CANCER
DUE  TO FAMILY HISTORY OR PRIOR PERSONAL HISTORY OF BREAST CANCER, POSI-
TIVE GENETIC TESTING OR OTHER INDICATIONS AS DETERMINED BY SUCH  WOMAN'S
PHYSICIAN OR NURSE PRACTITIONER.
  (II) SUCH ADDITIONAL COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND
COINSURANCE  AS  MAY  BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS
ARE CONSISTENT WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A  GIVEN
POLICY.
  (III)  EACH  MAMMOGRAPHY  REPORT  PROVIDED  TO A PATIENT SHALL INCLUDE
INFORMATION ABOUT BREAST DENSITY, BASED ON THE BREAST IMAGING  REPORTING
AND  DATA SYSTEM ESTABLISHED BY THE AMERICAN COLLEGE OF RADIOLOGY. WHERE
APPLICABLE, SUCH REPORT SHALL INCLUDE THE  FOLLOWING  NOTICE:  "IF  YOUR
MAMMOGRAM  DEMONSTRATES  THAT  YOU HAVE DENSE BREAST TISSUE, WHICH COULD
HIDE SMALL ABNORMALITIES, YOU MIGHT BENEFIT FROM SUPPLEMENTARY SCREENING
TESTS, DEPENDING ON YOUR INDIVIDUAL RISK FACTORS AND THE  RECOMMENDATION
OF  YOUR  INTERPRETING  PHYSICIAN. A REPORT OF YOUR MAMMOGRAPHY RESULTS,
WHICH CONTAINS INFORMATION ABOUT YOUR BREAST DENSITY, HAS BEEN  SENT  TO
YOUR  TREATING  PHYSICIAN'S  OFFICE AND YOU SHOULD CONTACT YOUR TREATING
PHYSICIAN IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR REPORT."
  S 3. Subsection (p) of section 4303 of the insurance law is amended by
adding a new paragraph 4 to read as follows:
  (4) (A) SUCH COVERAGE SHALL PROVIDE ADDITIONAL COVERAGE FOR COMPREHEN-
SIVE ULTRASOUND SCREENING,  MAGNETIC  RESONANCE  IMAGING  (MRI),  AND/OR
OTHER  SCREENING  TESTS APPROVED BY THE AMERICAN COLLEGE OF RADIOLOGY OF
AN ENTIRE BREAST OR THE ENTIRETY OF BOTH BREASTS IF:
  (I) A MAMMOGRAM DEMONSTRATES  HETEROGENEOUS  OR  DENSE  BREAST  TISSUE
BASED ON THE BREAST IMAGING REPORTING AND DATA SYSTEM ESTABLISHED BY THE
AMERICAN COLLEGE OF RADIOLOGY; OR
  (II) A WOMAN IS BELIEVED TO BE AT INCREASED RISK FOR BREAST CANCER DUE
TO  FAMILY  HISTORY OR PRIOR PERSONAL HISTORY OF BREAST CANCER, POSITIVE
GENETIC TESTING OR OTHER  INDICATIONS  AS  DETERMINED  BY  SUCH  WOMAN'S
PHYSICIAN OR NURSE PRACTITIONER.
  THE  ADDITIONAL  COVERAGE REQUIRED IN THIS SUBPARAGRAPH MAY BE SUBJECT
TO ANNUAL DEDUCTIBLES AND COINSURANCE AS MAY BE  DEEMED  APPROPRIATE  BY
THE  SUPERINTENDENT  AND  AS  ARE  CONSISTENT WITH THOSE ESTABLISHED FOR
OTHER BENEFITS WITHIN A GIVEN POLICY.
  (B) EACH MAMMOGRAPHY REPORT PROVIDED TO A PATIENT SHALL INCLUDE INFOR-
MATION ABOUT BREAST DENSITY, BASED ON THE BREAST IMAGING  REPORTING  AND

S. 1883--A                          3

DATA  SYSTEM  ESTABLISHED  BY  THE  AMERICAN COLLEGE OF RADIOLOGY. WHERE
APPLICABLE, SUCH REPORT SHALL INCLUDE THE  FOLLOWING  NOTICE:  "IF  YOUR
MAMMOGRAM  DEMONSTRATES  THAT  YOU HAVE DENSE BREAST TISSUE, WHICH COULD
HIDE SMALL ABNORMALITIES, YOU MIGHT BENEFIT FROM SUPPLEMENTARY SCREENING
TESTS,  DEPENDING ON YOUR INDIVIDUAL RISK FACTORS AND THE RECOMMENDATION
OF YOUR INTERPRETING PHYSICIAN. A REPORT OF  YOUR  MAMMOGRAPHY  RESULTS,
WHICH  CONTAINS  INFORMATION ABOUT YOUR BREAST DENSITY, HAS BEEN SENT TO
YOUR TREATING PHYSICIAN'S OFFICE AND YOU SHOULD  CONTACT  YOUR  TREATING
PHYSICIAN IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR REPORT."
  S  4.  Paragraph  7 of subsection (d) of section 4326 of the insurance
law, as added by chapter 1 of the laws of 1999, is amended  to  read  as
follows:
  (7) adult preventive health services consisting of mammography screen-
ing,  AS  PROVIDED  IN  SUBSECTION  (P)  OF  SECTION FOUR THOUSAND THREE
HUNDRED THREE OF THIS ARTICLE;  cervical  cytology  screening;  periodic
physical  examinations  no  more  than once every three years; and adult
immunizations;
  S 5. This act shall take effect on the sixtieth  day  after  it  shall
have become a law.

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