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.