S T A T E O F N E W Y O R K
________________________________________________________________________
1702
2017-2018 Regular Sessions
I N S E N A T E
January 10, 2017
___________
Introduced by Sen. PARKER -- 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 coverage for the
detection of breast cancer
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Subparagraph (A) of paragraph 11 of subsection (i) of
section 3216 of the insurance law, as amended by chapter 219 of the laws
of 2011, is amended and a new subparagraph (G) is added to read as
follows:
(A) Every policy that provides coverage for hospital, surgical or
medical care shall provide the following coverage for mammography
screening for occult breast cancer:
(i) upon the recommendation of a physician, a mammogram at any age for
covered persons having a prior history of breast cancer or who have a
first degree relative with a prior history of breast cancer;
(ii) a single baseline mammogram for covered persons aged [thirty-
five] TWENTY-FIVE through [thirty-nine] TWENTY-NINE, inclusive; and
(iii) an annual mammogram for covered persons aged [forty] THIRTY and
older.
(G) COVERAGE SHALL ALSO BE PROVIDED, UPON THE RECOMMENDATION OF A
PHYSICIAN, FOR FOLLOW-UP DIAGNOSTIC TESTING FOR THE DETECTION OF BREAST
CANCER, INCLUDING BREAST BIOPSIES, IN THE EVENT THAT A PHYSICIAN DETER-
MINES THAT A COVERED PERSON HAS HAD AN ABNORMAL MAMMOGRAM. SUCH FOLLOW-
UP DIAGNOSTIC TESTING SHALL NOT BE SUBJECT TO ANNUAL DEDUCTIBLES OR
COINSURANCE.
§ 2. Subparagraph (A) of paragraph 11 of subsection (l) of section
3221 of the insurance law, as amended by chapter 219 of the laws of
2011, is amended and a new subparagraph (G) is added to read as follows:
(A) Every insurer delivering a group or blanket policy or issuing a
group or blanket policy for delivery in this state that provides cover-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD05839-01-7
S. 1702 2
age for hospital, surgical or medical care shall provide the following
coverage for mammography screening for occult breast cancer:
(i) upon the recommendation of a physician, a mammogram at any age for
covered persons having a prior history of breast cancer or who have a
first degree relative with a prior history of breast cancer;
(ii) a single baseline mammogram for covered persons aged [thirty-
five] TWENTY-FIVE through [thirty-nine] TWENTY-NINE, inclusive; and
(iii) an annual mammogram for covered persons aged [forty] THIRTY and
older.
(G) COVERAGE SHALL ALSO BE PROVIDED, UPON THE RECOMMENDATION OF A
PHYSICIAN, FOR FOLLOW-UP DIAGNOSTIC TESTING FOR THE DETECTION OF BREAST
CANCER, INCLUDING BREAST BIOPSIES, IN THE EVENT THAT A PHYSICIAN DETER-
MINES THAT A COVERED PERSON HAS HAD AN ABNORMAL MAMMOGRAM. SUCH FOLLOW-
UP DIAGNOSTIC TESTING SHALL NOT BE SUBJECT TO ANNUAL DEDUCTIBLES OR
COINSURANCE.
§ 3. Paragraph 1 of subsection (p) of section 4303 of the insurance
law, as amended by chapter 219 of the laws of 2011, subparagraph (D) as
amended by chapter 74 of the laws of 2016, is amended and a new para-
graph 6 is added to read as follows:
(1) A medical expense indemnity corporation, a hospital service corpo-
ration or a health service corporation that provides coverage for hospi-
tal, surgical or medical care shall provide the following coverage for
mammography screening for occult breast cancer:
(A) upon the recommendation of a physician, a mammogram at any age for
covered persons having a prior history of breast cancer or who have a
first degree relative with a prior history of breast cancer;
(B) a single baseline mammogram for covered persons aged [thirty-five]
TWENTY-FIVE through [thirty-nine] TWENTY-NINE, inclusive; and
(C) an annual mammogram for covered persons aged [forty] THIRTY and
older.
(D) The coverage required in this paragraph or paragraph two of this
subsection shall not be subject to annual deductibles or coinsurance.
(6) COVERAGE SHALL ALSO BE PROVIDED, UPON THE RECOMMENDATION OF A
PHYSICIAN, FOR FOLLOW-UP DIAGNOSTIC TESTING FOR THE DETECTION OF BREAST
CANCER, INCLUDING BREAST BIOPSIES, IN THE EVENT THAT A PHYSICIAN DETER-
MINES THAT A COVERED PERSON HAS HAD AN ABNORMAL MAMMOGRAM. SUCH FOLLOW-
UP DIAGNOSTIC TESTING SHALL NOT BE SUBJECT TO ANNUAL DEDUCTIBLES OR
COINSURANCE.
§ 4. This act shall take effect on the ninetieth day after it shall
have become a law and shall apply to all policies and contracts issued,
renewed, modified, altered or amended on or after such date.