S1883-2011 Actions

• Mar 27, 2012: RECOMMIT, ENACTING CLAUSE STRICKEN
• Jan 4, 2012: REFERRED TO INSURANCE
• Jan 4, 2012: returned to senate
• Jan 4, 2012: died in assembly
• Jun 22, 2011: referred to insurance
• Jun 22, 2011: DELIVERED TO ASSEMBLY
• Jun 22, 2011: PASSED SENATE
• Jun 20, 2011: ORDERED TO THIRD READING CAL.1419
• Jun 20, 2011: COMMITTEE DISCHARGED AND COMMITTED TO RULES
• Feb 11, 2011: PRINT NUMBER 1883A
• Feb 11, 2011: AMEND (T) AND RECOMMIT TO INSURANCE
• Jan 13, 2011: REFERRED TO INSURANCE

S1883-2011 Memo

BILL NUMBER:S1883

TITLE OF BILL:
An act
to amend the insurance law, in relation to requiring health insurance
policies to cover comprehensive ultrasound screening and
magnetic resonance imaging
for breast cancer
in certain cases
and requiring the provision of certain information relating
to breast density to patients

PURPOSE:
This bill requires health insurance policies to provide additional
coverage for comprehensive ultrasound screening and/or magnetic
resonance imaging (MRI) examination of an entire breast or breasts if
a mammogram demonstrates dense breast tissue. It also requires
specific written notification to the patient of the availability of
such additional tests.

SUMMARY OF PROVISIONS:
Section one amends paragraph 11 of subsection (i) of section 3216 of
the Insurance Law by adding a new subparagraph (D) which specifies
that insurance policies provide coverage for comprehensive ultrasound
screening and/or magnetic resonance imaging (MRI) if a
mammogram demonstrates dense breast tissue, or if a woman is
believed to be at increased risk for breast cancer due to family
history, prior personal history, positive genetic testing or other
indications of breast cancer.

This new section also requires that each mammography report provided
to a patient include information about breast density and the
availability of supplemental comprehensive ultrasound screening for
breast cancer.

In addition, it provides that such additional coverage may be subject
to annual deductibles and coinsurance as may be deemed appropriate by
the superintendent and as are consistent with those established for
other benefits within a given policy.

Section two amends paragraph 11 of subsection (1) of section 3221 of
the Insurance Law by adding a new subparagraph (D) to read exactly
the same as section one above.

Section three amends subsection (p) of section 4303 of the Insurance
Law by adding a new paragraph (4) to read exactly the same as
section one above.

Section four amends paragraph 7 of subsection (d) of section 4326 of
the Insurance Law, as added by chapter 1 of the laws of 1999 by
adding a cross reference to subsection (p) of section 4303 of the
Insurance Law.

Section five provides that this act shall take effect on the sixtieth
day after it shall have become a law.


EXISTING LAW:
Currently, the decision to refer a patient for a follow up ultrasound
screening or an MRI subsequent to a mammogram which reveals dense
breast tissue is discretionary with the physician. Many times the
patient is not even aware of the fact that she has dense breast tissue.

JUSTIFICATION:
Breast cancer is the most frequently diagnosed cancer among women.
Cancer is five times more likely in women with dense breast tissue.

Mammograms can miss up to 40% of tumors present in dense breast
tissue as denser tissue tends to obscure tumors.  Ultrasound screening
and/or an MRI examinations, and/or other screening tests approved
by the American College of Radiology, after a mammography reveals
dense breast tissue can help doctors detect the presence of a tumor.

Post mammogram written notification to patients with dense breast
tissue will keep patients informed. Raising awareness of breast
density is very important. Assisting physicians and patients in the
detection of early stage cancers serves to make them more treatable.

The State of Connecticut has already enacted this law. The States of
Florida, California, and Texas are in the process of considering it.

LEGISLATIVE HISTORY:
2010:  S.8488 Rules

FISCAL IMPLICATIONS:
None.

LOCAL FISCAL IMPLICATIONS:
None.

EFFECTIVE DATE:
This bill takes effect on the sixtieth day after it shall have become
a law.

S1883-2011 Text

 S T A T E   O F   N E W   Y O R K
 
 
                                         1883
 2011-2012 Regular Sessions
 I N  SENATE
 January 13, 2011
 
 Introduced  by Sen. FLANAGAN -- 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  requiring  health
 insurance  policies  to  cover  comprehensive ultrasound screening and
 magnetic resonance imaging for breast  cancer  in  certain  cases  and
 requiring  the  provision  of  certain  information relating to breast
 density to patients
 THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM
 BLY, DO ENACT AS FOLLOWS:

 

Section  1.  Paragraph  11  of  subsection  (i) of section 3216 of the
 insurance law is amended by adding a new subparagraph  (D)  to  read  as
 follows:

 (D)  (I)  SUCH POLICY SHALL PROVIDE ADDITIONAL COVERAGE FOR COMPREHEN
 SIVE ULTRASOUND SCREENING,  MAGNETIC  RESONANCE  IMAGING  (MRI),  AND/OR
 OTHER  SCREENING  TESTS APPROVED BY THE AMERICAN COLLEGE OF RADIOLOGY OF
 AN ENTIRE BREAST OR THE ENTIRETY OF BOTH BREASTS IF:

 (I) A MAMMOGRAM DEMONSTRATES  HETEROGENEOUS  OR  DENSE  BREAST  TISSUE
 BASED ON THE BREAST IMAGING REPORTING AND DATA SYSTEM ESTABLISHED BY THE
 AMERICAN COLLEGE OF RADIOLOGY; OR
 (II) A WOMAN IS BELIEVED TO BE AT INCREASED RISK FOR BREAST CANCER DUE
 TO  FAMILY  HISTORY OR PRIOR PERSONAL HISTORY OF BREAST CANCER, POSITIVE
 GENETIC TESTING OR OTHER  INDICATIONS  AS  DETERMINED  BY  SUCH  WOMAN'S
 PHYSICIAN OR NURSE PRACTITIONER.
 (II) SUCH ADDITIONAL COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND
 COINSURANCE  AS  MAY  BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS
 ARE CONSISTENT WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A  GIVEN
 POLICY.
 (III)  EACH  MAMMOGRAPHY  REPORT  PROVIDED  TO A PATIENT SHALL INCLUDE
 INFORMATION ABOUT BREAST DENSITY, BASED ON THE BREAST IMAGING  REPORTING
 AND  DATA SYSTEM ESTABLISHED BY THE AMERICAN COLLEGE OF RADIOLOGY. WHERE
 APPLICABLE, SUCH REPORT SHALL INCLUDE THE  FOLLOWING  NOTICE:  "IF  YOUR
 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD00386-02-1
 
       S. 1883                             2
 MAMMOGRAM  DEMONSTRATES  THAT  YOU HAVE DENSE BREAST TISSUE, WHICH COULD
 HIDE SMALL ABNORMALITIES, YOU MIGHT BENEFIT FROM SUPPLEMENTARY SCREENING
 TESTS, WHICH CAN INCLUDE A BREAST ULTRASOUND SCREENING OR A  BREAST  MRI
 EXAMINATION,  OR  BOTH,  DEPENDING  ON  YOUR  INDIVIDUAL RISK FACTORS. A
 REPORT OF YOUR MAMMOGRAPHY RESULTS,  WHICH  CONTAINS  INFORMATION  ABOUT
 YOUR  BREAST  DENSITY,  HAS BEEN SENT TO YOUR PHYSICIAN'S OFFICE AND YOU
 SHOULD CONTACT YOUR PHYSICIAN IF YOU  HAVE  ANY  QUESTIONS  OR  CONCERNS
 ABOUT THIS REPORT."
 

S  2.  Paragraph 11 of subsection (l) of section 3221 of the insurance
 law is amended by adding a new subparagraph (D) to read as follows:

 (D) (I) SUCH POLICY SHALL PROVIDE ADDITIONAL COVERAGE  FOR  COMPREHEN
 SIVE  ULTRASOUND  SCREENING,  MAGNETIC  RESONANCE  IMAGING (MRI), AND/OR
 OTHER SCREENING TESTS APPROVED BY THE AMERICAN COLLEGE OF  RADIOLOGY  OF
 AN ENTIRE BREAST OR THE ENTIRETY OF BOTH BREASTS IF:

 (I)  A  MAMMOGRAM  DEMONSTRATES  HETEROGENEOUS  OR DENSE BREAST TISSUE
 BASED ON THE BREAST IMAGING REPORTING AND DATA SYSTEM ESTABLISHED BY THE
 AMERICAN COLLEGE OF RADIOLOGY; OR
 (II) A WOMAN IS BELIEVED TO BE AT AN INCREASED RISK FOR BREAST  CANCER
 DUE  TO FAMILY HISTORY OR PRIOR PERSONAL HISTORY OF BREAST CANCER, POSI
 TIVE GENETIC TESTING OR OTHER INDICATIONS AS DETERMINED BY SUCH  WOMAN'S
 PHYSICIAN OR NURSE PRACTITIONER.
 (II) SUCH ADDITIONAL COVERAGE MAY BE SUBJECT TO ANNUAL DEDUCTIBLES AND
 COINSURANCE  AS  MAY  BE DEEMED APPROPRIATE BY THE SUPERINTENDENT AND AS
 ARE CONSISTENT WITH THOSE ESTABLISHED FOR OTHER BENEFITS WITHIN A  GIVEN
 POLICY.
 (III)  EACH  MAMMOGRAPHY  REPORT  PROVIDED  TO A PATIENT SHALL INCLUDE
 INFORMATION ABOUT BREAST DENSITY, BASED ON THE BREAST IMAGING  REPORTING
 AND  DATA SYSTEM ESTABLISHED BY THE AMERICAN COLLEGE OF RADIOLOGY. WHERE
 APPLICABLE, SUCH REPORT SHALL INCLUDE THE  FOLLOWING  NOTICE:  "IF  YOUR
 MAMMOGRAM  DEMONSTRATES  THAT  YOU HAVE DENSE BREAST TISSUE, WHICH COULD
 HIDE SMALL ABNORMALITIES, YOU MIGHT BENEFIT FROM SUPPLEMENTARY SCREENING
 TESTS, WHICH CAN INCLUDE A BREAST ULTRASOUND SCREENING OR A  BREAST  MRI
 EXAMINATION,  OR  BOTH,  DEPENDING  ON  YOUR  INDIVIDUAL RISK FACTORS. A
 REPORT OF YOUR MAMMOGRAPHY RESULTS,  WHICH  CONTAINS  INFORMATION  ABOUT
 YOUR  BREAST  DENSITY,  HAS BEEN SENT TO YOUR PHYSICIAN'S OFFICE AND YOU
 SHOULD CONTACT YOUR PHYSICIAN IF YOU  HAVE  ANY  QUESTIONS  OR  CONCERNS
 ABOUT THIS REPORT."
 

S 3. Subsection (p) of section 4303 of the insurance law is amended by
 adding a new paragraph 4 to read as follows:

 (4) (A) SUCH COVERAGE SHALL PROVIDE ADDITIONAL COVERAGE FOR COMPREHEN
 SIVE  ULTRASOUND  SCREENING,  MAGNETIC  RESONANCE  IMAGING (MRI), AND/OR
 OTHER SCREENING TESTS APPROVED BY THE AMERICAN COLLEGE OF  RADIOLOGY  OF
 AN ENTIRE BREAST OR THE ENTIRETY OF BOTH BREASTS IF:

 (I)  A  MAMMOGRAM  DEMONSTRATES  HETEROGENEOUS  OR DENSE BREAST TISSUE
 BASED ON THE BREAST IMAGING REPORTING AND DATA SYSTEM ESTABLISHED BY THE
 AMERICAN COLLEGE OF RADIOLOGY; OR
 (II) A WOMAN IS BELIEVED TO BE AT INCREASED RISK FOR BREAST CANCER DUE
 TO FAMILY HISTORY OR PRIOR PERSONAL HISTORY OF BREAST  CANCER,  POSITIVE
 GENETIC  TESTING  OR  OTHER  INDICATIONS  AS  DETERMINED BY SUCH WOMAN'S
 PHYSICIAN OR NURSE PRACTITIONER.
 THE ADDITIONAL COVERAGE REQUIRED IN THIS SUBPARAGRAPH MAY  BE  SUBJECT
 TO  ANNUAL  DEDUCTIBLES  AND COINSURANCE AS MAY BE DEEMED APPROPRIATE BY
 THE SUPERINTENDENT AND AS ARE  CONSISTENT  WITH  THOSE  ESTABLISHED  FOR
 OTHER BENEFITS WITHIN A GIVEN POLICY.
 (B) EACH MAMMOGRAPHY REPORT PROVIDED TO A PATIENT SHALL INCLUDE INFOR
 MATION  ABOUT  BREAST DENSITY, BASED ON THE BREAST IMAGING REPORTING AND
 
       S. 1883                             3
 DATA SYSTEM ESTABLISHED BY THE  AMERICAN  COLLEGE  OF  RADIOLOGY.  WHERE
 APPLICABLE,  SUCH  REPORT  SHALL  INCLUDE THE FOLLOWING NOTICE: "IF YOUR
 MAMMOGRAM DEMONSTRATES THAT YOU HAVE DENSE BREAST  TISSUE,  WHICH  COULD
 HIDE SMALL ABNORMALITIES, YOU MIGHT BENEFIT FROM SUPPLEMENTARY SCREENING
 TESTS,  WHICH  CAN INCLUDE A BREAST ULTRASOUND SCREENING OR A BREAST MRI
 EXAMINATION, OR BOTH, DEPENDING  ON  YOUR  INDIVIDUAL  RISK  FACTORS.  A
 REPORT  OF  YOUR  MAMMOGRAPHY  RESULTS, WHICH CONTAINS INFORMATION ABOUT
 YOUR BREAST DENSITY, HAS BEEN SENT TO YOUR PHYSICIAN'S  OFFICE  AND  YOU
 SHOULD  CONTACT  YOUR  PHYSICIAN  IF  YOU HAVE ANY QUESTIONS OR CONCERNS
 ABOUT THIS REPORT."
 

S 4. Paragraph 7 of subsection (d) of section 4326  of  the  insurance
 law,  as  added  by chapter 1 of the laws of 1999, is amended to read as
 follows:

 (7) adult preventive health services consisting of mammography screen
 ing, AS PROVIDED IN  SUBSECTION  (P)  OF  SECTION  FOUR  THOUSAND  THREE
 HUNDRED  THREE  OF  THIS  ARTICLE; cervical cytology screening; periodic
 physical examinations no more than once every  three  years;  and  adult
 immunizations;
 

S  5.  This  act  shall take effect on the sixtieth day after it shall
 have become a law.

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