S T A T E O F N E W Y O R K
________________________________________________________________________
6561
2025-2026 Regular Sessions
I N A S S E M B L Y
March 6, 2025
___________
Introduced by M. of A. WEPRIN -- read once and referred to the Committee
on Insurance
AN ACT to amend the insurance law, in relation to including image-guided
biopsies under certain insurance coverage for breast cancer screening
and providing for mandatory health insurance coverage for lung cancer
screening
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
Section 1. Item (iv) of subparagraph (A) of paragraph 11 of subsection
(i) of section 3216 of the insurance law, as amended by chapter 424 of
the laws of 2024, is amended to read as follows:
(iv) upon the recommendation of a physician, screening and diagnostic
imaging, including diagnostic mammograms, breast ultrasounds, IMAGE-
GUIDED BREAST BIOPSIES, or magnetic resonance imaging, recommended by
nationally recognized clinical practice guidelines for the detection of
breast cancer. For the purposes of this item, "nationally recognized
clinical practice guidelines" means evidence-based clinical practice
guidelines informed by a systematic review of evidence and an assessment
of the benefits, and risks of alternative care options intended to opti-
mize patient care developed by independent organizations or medical
professional societies utilizing a transparent methodology and reporting
structure and with a conflict of interest policy.
§ 2. Item (v) of subparagraph (A) of paragraph 11 of subsection (l) of
section 3221 of the insurance law, as amended by chapter 424 of the laws
of 2024, is amended to read as follows:
(v) upon the recommendation of a physician, screening and diagnostic
imaging, including diagnostic mammograms, breast ultrasounds, IMAGE-
GUIDED BREAST BIOPSIES, or magnetic resonance imaging, recommended by
nationally recognized clinical practice guidelines for the detection of
breast cancer. For the purposes of this item, "nationally recognized
clinical practice guidelines" means evidence-based clinical practice
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10190-02-5
A. 6561 2
guidelines informed by a systematic review of evidence and an assessment
of the benefits, and risks of alternative care options intended to opti-
mize patient care developed by independent organizations or medical
professional societies utilizing a transparent methodology and reporting
structure and with a conflict of interest policy.
§ 3. Subparagraph (E) of paragraph 1 of subsection (p) of section 4303
of the insurance law, as amended by chapter 424 of the laws of 2024, is
amended to read as follows:
(E) upon the recommendation of a physician, screening and diagnostic
imaging, including diagnostic mammograms, breast ultrasounds, IMAGE-
GUIDED BREAST BIOPSIES, or magnetic resonance imaging, recommended by
nationally recognized clinical practice guidelines for the detection of
breast cancer. For the purposes of this subparagraph, "nationally recog-
nized clinical practice guidelines" means evidence-based clinical prac-
tice guidelines informed by a systematic review of evidence and an
assessment of the benefits, and risks of alternative care options
intended to optimize patient care developed by independent organizations
or medical professional societies utilizing a transparent methodology
and reporting structure and with a conflict of interest policy; and
§ 4. Subsection (i) of section 3216 of the insurance law is amended by
adding a new paragraph 41 to read as follows:
(41) (A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMI-
LAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR LUNG CANCER
SCREENING OR FOLLOW-UP DIAGNOSTIC IMAGING TO ASSIST IN THE DIAGNOSIS OF
LUNG CANCER WHEN RECOMMENDED BY A HEALTH CARE PROVIDER ACTING WITHIN THE
PROVIDER'S SCOPE OF PRACTICE PURSUANT TO TITLE EIGHT OF THE EDUCATION
LAW.
(B) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ANY POLICY THAT
PROVIDES COVERAGE REQUIRED BY THIS PARAGRAPH SHALL NOT IMPOSE A COPAY-
MENT, COINSURANCE, OR DEDUCTIBLE REQUIREMENT FOR LUNG CANCER SCREENING
OR FOLLOW-UP DIAGNOSTIC IMAGING TO ASSIST IN THE DIAGNOSIS OF LUNG
CANCER AND SHALL NOT REQUIRE PRIOR AUTHORIZATION FOR SUCH COVERAGE.
§ 5. Subsection (l) of section 3221 of the insurance law is amended by
adding a new paragraph 23 to read as follows:
(23) (A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMI-
LAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR LUNG CANCER
SCREENING OR FOLLOW-UP DIAGNOSTIC IMAGING TO ASSIST IN THE DIAGNOSIS OF
LUNG CANCER WHEN RECOMMENDED BY A HEALTH CARE PROVIDER ACTING WITHIN THE
PROVIDER'S SCOPE OF PRACTICE PURSUANT TO TITLE EIGHT OF THE EDUCATION
LAW.
(B) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ANY POLICY THAT
PROVIDES COVERAGE REQUIRED BY THIS PARAGRAPH SHALL NOT IMPOSE A COPAY-
MENT, COINSURANCE, OR DEDUCTIBLE REQUIREMENT FOR LUNG CANCER SCREENING
OR FOLLOW-UP DIAGNOSTIC IMAGING TO ASSIST IN THE DIAGNOSIS OF LUNG
CANCER AND SHALL NOT REQUIRE PRIOR AUTHORIZATION FOR SUCH COVERAGE.
§ 6. Section 4303 of the insurance law is amended by adding a new
subsection (ww) to read as follows:
(WW) (1) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMI-
LAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR LUNG CANCER
SCREENING OR FOLLOW-UP DIAGNOSTIC IMAGING TO ASSIST IN THE DIAGNOSIS OF
LUNG CANCER WHEN RECOMMENDED BY A HEALTH CARE PROVIDER ACTING WITHIN THE
PROVIDER'S SCOPE OF PRACTICE PURSUANT TO TITLE EIGHT OF THE EDUCATION
LAW.
(2) NOTWITHSTANDING ANY OTHER PROVISION OF LAW, ANY POLICY THAT
PROVIDES COVERAGE REQUIRED BY THIS SUBSECTION SHALL NOT IMPOSE A COPAY-
MENT, COINSURANCE, OR DEDUCTIBLE REQUIREMENT FOR LUNG CANCER SCREENING
A. 6561 3
OR FOLLOW-UP DIAGNOSTIC IMAGING TO ASSIST IN THE DIAGNOSIS OF LUNG
CANCER AND SHALL NOT REQUIRE PRIOR AUTHORIZATION FOR SUCH COVERAGE.
§ 7. This act shall take effect January 1, 2026 and shall apply to all
policies and contracts issued, renewed, modified, altered or amended on
or after such date; provided, however, that if chapter 424 of the laws
of 2024 shall not have taken effect on or before such date then sections
one, two and three of this act shall take effect on the same date and in
the same manner as such chapter of the laws of 2024 takes effect.