Bill S1883A-2011

Requires health insurance policies to cover comprehensive ultrasound screening and magnetic resonance imaging for breast cancer in certain cases

Requires individual and group health insurance policies, and health maintenance organizations to provide coverage for comprehensive ultrasound screening, magnetic resonance imaging and/or other screening tests for breast cancer in certain cases; requires mammography reports to include information about breast density.

Details

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

Meetings

Votes

Memo

BILL NUMBER:S1883A

TITLE OF BILL: An act to amend the insurance law, in relation to requiring health insurance policies to cover comprehensive ultrasound screening, magnetic resonance imaging and/or other screening tests 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 supplementary screening tests of an entire breast or breasts if a mammogram demonstrates dense breast tissue. It also requires specific written notification to the patient of their breast density and 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, magnetic resonance imaging (MRI), and/or other screening tests approved by the American College of Radiology 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 their breast density and the availability of supplemental screening tests 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 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, 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. Early detection is key to the successful treatment of cancer.

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.


Text

STATE OF NEW YORK ________________________________________________________________________ 1883--A 2011-2012 Regular Sessions IN SENATE January 13, 2011 ___________
Introduced by Sens. FLANAGAN, BONACIC -- 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 requiring health insurance policies to cover comprehensive ultrasound screening, magnetic resonance imaging and/or other screening tests for breast cancer in certain cases and requiring the provision of certain infor- mation 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 MAMMOGRAM DEMONSTRATES THAT YOU HAVE DENSE BREAST TISSUE, WHICH COULD HIDE SMALL ABNORMALITIES, YOU MIGHT BENEFIT FROM SUPPLEMENTARY SCREENING TESTS, DEPENDING ON YOUR INDIVIDUAL RISK FACTORS AND THE RECOMMENDATION OF YOUR INTERPRETING PHYSICIAN. A REPORT OF YOUR MAMMOGRAPHY RESULTS, WHICH CONTAINS INFORMATION ABOUT YOUR BREAST DENSITY, HAS BEEN SENT TO YOUR TREATING PHYSICIAN'S OFFICE AND YOU SHOULD CONTACT YOUR TREATING PHYSICIAN IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR 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, DEPENDING ON YOUR INDIVIDUAL RISK FACTORS AND THE RECOMMENDATION OF YOUR INTERPRETING PHYSICIAN. A REPORT OF YOUR MAMMOGRAPHY RESULTS, WHICH CONTAINS INFORMATION ABOUT YOUR BREAST DENSITY, HAS BEEN SENT TO YOUR TREATING PHYSICIAN'S OFFICE AND YOU SHOULD CONTACT YOUR TREATING PHYSICIAN IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR 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
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, DEPENDING ON YOUR INDIVIDUAL RISK FACTORS AND THE RECOMMENDATION OF YOUR INTERPRETING PHYSICIAN. A REPORT OF YOUR MAMMOGRAPHY RESULTS, WHICH CONTAINS INFORMATION ABOUT YOUR BREAST DENSITY, HAS BEEN SENT TO YOUR TREATING PHYSICIAN'S OFFICE AND YOU SHOULD CONTACT YOUR TREATING PHYSICIAN IF YOU HAVE ANY QUESTIONS OR CONCERNS ABOUT YOUR 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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