NY State Senate Bill 2025-S4072

Current Bill Status - In Senate Committee Insurance Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 31, 2025	referred to insurance

co-Sponsors

2025-S4072 (ACTIVE) - Details

Current Committee:: Senate Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3221 & 4303, Ins L
Versions Introduced in 2023-2024 Legislative Session:: S7921

2025-S4072 (ACTIVE) - Summary

Requires insurance coverage of sonograms and other diagnostic procedures used to detect breast cancer for covered persons with a prior history of breast cancer or who have a first degree relative with a prior history of breast cancer.

2025-S4072 (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S4072

SPONSOR: BYNOE
 
TITLE OF BILL:

An act to amend the insurance law, in relation to coverage of certain
procedures to detect breast cancer

 
PURPOSE:

This purpose of this bill is expand breast cancer screenings for covered
persons who have a prior history of breast cancer or who have a first
degree relative with a prior history of breast cancer, or have had any
sonogram or other diagnostic procedure used to detect breast cancer.

 
SUMMARY OF PROVISIONS:

Section 1 of this bill would require a group or blanket policy insurer
to expand breast cancer screenings for covered persons who have a prior
history of breast cancer or who have a first degree relative with a
prior history of breast cancer, or have had any sonogram or other diag-
nostic procedure used to detect breast cancer.

Section 2 of this bill would require a medical expense indemnity corpo-
ration, a hospital service corporation or a health service corporation
that offers large group contracts to offer breast cancer screenings for
covered persons who have a prior history of breast cancer or who have a
first degree relative with a prior history of breast cancer, or have had
any sonogram or other diagnostic procedure used to detect breast cancer.

Section 3 of this bill would establish an effective date that shall take
effect on the same date and in the same manner as chapter 424 of the
laws of 2024, takes effect.

 
JUSTIFICATION:

New Yorkers are suffering from an increase in breast cancer. Breast
Cancer is the most diagnosed form of cancer among U.S. women. Each year,
about 30% of all newly diagnosed cancers in women are breast cancer.
According to the data from Breatcancer.org, approximately 13% (about one
in eight) of U.S. women are going to develop invasive breast cancer
during their life. This pattern is replicated in New York State. Accord-
ing to data from Department of Health, breast cancer is one of the most
common cancers among women. Specifically, each year approximately 16,700
women are diagnosed with breast cancer, and about 2,500 women die from
the disease.

On Long Island, incidents of breast cancer are thirteen to eighteen
percent higher than the statewide average, according to The Department
of Health and Human Services, National Institutes of Health National
Cancer Institute, National Institute of Environmental Health Sciences,
as released in the November 2004 "Report to the U.S.  Congress: The Long
Island Breast Cancer Study Project."

Cancer is an insidious malignancy that thrives when hidden. Providing
additional viable detection options at an earlier age for diagnostic
testing, as determined appropriate by a patient's own physicians, will
lead to earlier diagnosis based upon each patient's unique situation.

New Yorkers should have a fighting chance against this malicious disease
by bringing more health information to light.

This bill would expand breast cancer screenings for covered persons who
have a prior history of breast cancer or who have a first degree rela-
tive with a prior history of breast cancer, or have had any sonogram or
other diagnostic procedure used to detect breast cancer.

 
LEGISLATIVE HISTORY:

New bill.

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect on the same date and in the same manner as
chapter 424 of the laws of 2024, takes effect.

2025-S4072 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4072
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                             January 31, 2025
                                ___________
 
 Introduced by Sens. BYNOE, 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 424 of the laws
 of 2024, 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  tomosyn-
 thesis, for covered persons aged forty and older;
   (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; and
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01242-01-5
 S. 4072                             2

 
   [(v)] (IV) upon the recommendation of a physician, screening and diag-
 nostic  imaging, including diagnostic mammograms, breast ultrasounds, or
 magnetic resonance imaging, recommended by nationally  recognized  clin-
 ical  practice  guidelines  for  the detection of breast cancer. For the
 purposes  of  this item, "nationally recognized clinical practice guide-
 lines" 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  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.
   § 2. Subparagraph (D) 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:
   (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;
   § 3. This act shall take effect on the  same  date  and  in  the  same
 manner as chapter 424 of the laws of 2024, takes effect.

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Senate Bill S4072

Sponsored By

Current Bill Status - In Senate Committee Insurance Committee

co-Sponsors

2025-S4072 (ACTIVE) - Details

2025-S4072 (ACTIVE) - Summary

2025-S4072 (ACTIVE) - Sponsor Memo

2025-S4072 (ACTIVE) - Bill Text download pdf

Comments

Senate Bill S4072

Share this bill

Sponsored By

Siela A. Bynoe

Current Bill Status - In Senate Committee Insurance Committee

co-Sponsors

Steven D. Rhoads

2025-S4072 (ACTIVE) - Details

2025-S4072 (ACTIVE) - Summary

2025-S4072 (ACTIVE) - Sponsor Memo

2025-S4072 (ACTIVE) - Bill Text download pdf

Comments