Senate Bill S7921

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  7921--A
 
                             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  --  committee
   discharged, bill amended, ordered reprinted as amended and recommitted
   to said committee
 
 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]; AND
   (iii) [an annual mammogram, which may be provided by  breast  tomosyn-
 thesis, 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] MAMMOGRAMS  for  covered
 persons [aged thirty-five through thirty-nine, inclusive] HAVING A PRIOR
 HISTORY  OF  BREAST  CANCER  OR  WHO HAVE A FIRST DEGREE RELATIVE WITH A
 PRIOR HISTORY OF BREAST CANCER, OR  ANY  SONOGRAM  OR  OTHER  DIAGNOSTIC
 PROCEDURE  USED  TO  DETECT  BREAST CANCER, upon the recommendation of a
 physician, subject to the insurer's determination that the mammogram  is
 medically necessary.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11825-03-4
 S. 7921--A                          2
              

 
   § 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
 annual  mammogram]  MAMMOGRAMS  for  covered  persons  [aged thirty-five
 through thirty-nine, inclusive] HAVING A PRIOR HISTORY OF BREAST  CANCER
 OR  WHO  HAVE  A  FIRST  DEGREE  RELATIVE WITH A PRIOR HISTORY OF BREAST
 CANCER, 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.