Senate Bill S7280

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7280
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                               April 8, 2025
                                ___________
 
 Introduced  by Sen. MARTINEZ -- 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 reducing  the  age  of
   receiving  annual  mammograms  for  persons  enrolled in certain large
   group policies

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Short  title. This act shall be known and may be cited as
 "Shannon's Law".
   § 2. 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 tomosynthe-
 sis, for covered persons aged forty and older;
   (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, upon the recommen-
 dation 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.
                                                            LBD11351-01-5
 S. 7280                             2
              

 
   (v)  upon  the recommendation of a physician, screening and diagnostic
 imaging, including diagnostic mammograms, breast ultrasounds, or magnet-
 ic 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 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.
   § 3. 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 for covered persons aged [thirty-five]  THIRTY  through
 thirty-nine,  inclusive, upon the recommendation of a physician, subject
 to the corporation's  determination  that  the  mammogram  is  medically
 necessary; and
   §  4.  This  act  shall  take  effect on the same date and in the same
 manner as chapter 424 of the laws of 2024, takes effect and shall  apply
 to  policies and contracts issued, renewed, modified, altered or amended
 on or after such effective date.