S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7921
 
                             I N  S E N A T E
 
                              January 3, 2024
                                ___________
 
 Introduced  by  Sen.  RHOADS -- 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  of  certain
   procedures to detect 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  (l)  of
 section 3221 of the insurance law, as amended by chapter 143 of the laws
 of 2019, is amended 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-
 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, which may  be
 provided  by breast tomosynthesis, 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,  which may be provided by breast
 tomosynthesis, for covered persons aged thirty-five through thirty-nine,
 inclusive;
   (iii) an annual mammogram, which may be provided by breast tomosynthe-
 sis, for covered persons aged forty and older; and
   (iv) for large group policies  that  provide  coverage  for  hospital,
 surgical  or  medical care, an annual mammogram for covered persons aged
 [thirty-five] THIRTY through thirty-nine, inclusive, OR ANY SONOGRAM  OR
 OTHER DIAGNOSTIC PROCEDURE USED TO DETECT BREAST CANCER, upon the recom-
 mendation  of  a  physician, subject to the insurer's determination that
 the mammogram is medically necessary.
   § 2. Subparagraph (D) of paragraph 1 of subsection (p) of section 4303
 of the insurance law, as amended by chapter 143 of the laws of 2019,  is
 amended to read as follows:
   (D)  for  large group contracts offered by a medical expense indemnity
 corporation, a hospital service corporation or a health  service  corpo-
 ration  that provide coverage for hospital, surgical or medical care, an
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD11825-02-3
 S. 7921                             2
 
 annual mammogram for covered persons aged [thirty-five]  THIRTY  through
 thirty-nine,  inclusive,  OR  ANY SONOGRAM OR OTHER DIAGNOSTIC PROCEDURE
 USED TO DETECT BREAST CANCER, upon the recommendation  of  a  physician,
 subject  to  the  corporation's  determination  that  the  mammogram  is
 medically necessary; and
   § 3. This act shall take effect on the thirtieth day  after  it  shall
 have  become  a  law,  and shall apply to policies and contracts issued,
 renewed, modified, altered or amended on or after such effective date.