Enacts "Shannon's law"; relates to requiring insurance companies to cover annual mammograms for breast cancer screening for covered persons aged thirty-five and older.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A5502A
SPONSOR: Jean-Pierre (MS) TITLE OF BILL:
An act to amend the insurance law, in relation to enacting "Shannon's
Law"
PURPOSE OR GENERAL IDEA OF BILL:
This bill would increase access to annual breast exams for New Yorker's
aged thirty-five through thirty-nine.
SUMMARY OF PROVISIONS:
Section 1. Provides that this act shall be known as "Shannon's Law"
Section 2. Amends subparagraph (A) of paragraph 11 of subsection (i) of
§ 3221 of the insurance law to require large group policy that provides
cover age for hospital, surgical, or medical care to provide coverage
for an annual mammogram for covered persons aged thirty-five through
thirty- nine upon the recommendation of a physician, subject to medical
necessity.
Section 3. Amends paragraph 1 of subsection (p) of § 4303 of the insur-
ance law to require large group contract offered by medical expense
indemnity corporation, hospital service corporation or health service
corporation that provides coverage for hospital, surgical or medical
care to provide coverage for an annual mammogram for covered persons
aged thirty-five through thirty-nine upon the recommendation of a physi-
cian, subject to medical necessity.
Section 4. Sets forth the effective date.
DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE):
Amended bill provides that insurers are required to provide coverage of
annual mammograms upon the recommendation of a physician.
JUSTIFICATION:
One in 227 women in the U.S. will be diagnosed with breast cancer
between the ages of 30 and 40. It is estimated that 13,110 cases of
breast cancer will be in women under age 40 and approximately 26,275
women will be under 45 years of age. Women ages 15 to 34 and 35 to 54
die more frequently from breast cancer than other cancer. In Suffolk and
Nassau counties alone, there is a new diagnosis every week. We can no
longer overlook that this is now an epidemic. Young women generally face
more aggressive cancers and lower survival rates. The current informa-
tion provided for breast health is not meant for the younger generation.
There is a lack of resources regarding this "global crisis" in the
curriculum. Revision of the current mammogram age recommendations bene-
fits will outweigh the risks. This legislation would give young women
the opportunity to seek early detection and the life-saving power of
intervention.
PRIOR LEGISLATIVE HISTORY:
A.6731-C of 2018
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
None.
EFFECTIVE DATE:
This act shall take effect the thirtieth day after it shall have become
law.
STATE OF NEW YORK
________________________________________________________________________
5502--A
2019-2020 Regular Sessions
IN ASSEMBLY
February 13, 2019
___________
Introduced by M. of A. JEAN-PIERRE, COOK, WALKER, COLTON, JAFFEE, HYND-
MAN, DICKENS, ZEBROWSKI, SIMON, D'URSO, ROZIC, ABINANTI, BLAKE, McDO-
NOUGH, M. L. MILLER, PALUMBO, WRIGHT, JOYNER, BRABENEC, GARBARINO,
LiPETRI, TITUS, RAIA -- Multi-Sponsored by -- M. of A. THIELE -- read
once and referred to the Committee on Insurance -- reported and
referred to the Committee on Codes -- reported and referred to the
Committee on Ways and Means -- committee discharged, bill amended,
ordered reprinted as amended and recommitted to said committee
AN ACT to amend the insurance law, in relation to enacting "Shannon's
Law"
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Short title. This act shall be known and may be cited as
2 "Shannon's Law".
3 § 2. Subparagraph (A) of paragraph 11 of subsection (l) of section
4 3221 of the insurance law, as amended by chapter 414 of the laws of
5 2017, is amended to read as follows:
6 (A) Every insurer delivering a group or blanket policy or issuing a
7 group or blanket policy for delivery in this state that provides cover-
8 age for hospital, surgical or medical care shall provide the following
9 coverage for mammography screening for occult breast cancer:
10 (i) upon the recommendation of a physician, a mammogram, which may be
11 provided by breast tomosynthesis, at any age for covered persons having
12 a prior history of breast cancer or who have a first degree relative
13 with a prior history of breast cancer;
14 (ii) a single baseline mammogram, which may be provided by breast
15 tomosynthesis, for covered persons aged thirty-five through thirty-nine,
16 inclusive; [and]
17 (iii) an annual mammogram, which may be provided by breast tomosynthe-
18 sis, for covered persons aged forty and older[.]; and
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09044-03-9
A. 5502--A 2
1 (iv) for large group policies that provide coverage for hospital,
2 surgical or medical care, an annual mammogram for covered persons aged
3 thirty-five through thirty-nine, inclusive, upon the recommendation of a
4 physician, subject to the insurer's determination that the mammogram is
5 medically necessary.
6 § 3. Subparagraphs (B), (C) and (D) of paragraph 1 of subsection (p)
7 of section 4303 of the insurance law, subparagraphs (B) and (C) as
8 amended by chapter 414 of the laws of 2017, subparagraph (D) as amended
9 by chapter 74 of the laws of 2016, are amended to read as follows:
10 (B) a single baseline mammogram, which may be provided by breast tomo-
11 synthesis, for covered persons aged thirty-five through thirty-nine,
12 inclusive; [and]
13 (C) an annual mammogram, which may be provided by breast tomosythesis,
14 for covered persons aged forty and older[.];
15 (D) for large group contracts offered by a medical expense indemnity
16 corporation, a hospital service corporation or a health service corpo-
17 ration that provide coverage for hospital, surgical or medical care, an
18 annual mammogram for covered persons aged thirty-five through thirty-
19 nine, inclusive, upon the recommendation of a physician, subject to the
20 corporation's determination that the mammogram is medically necessary;
21 and
22 (E) The coverage required in this paragraph or paragraph two of this
23 subsection shall not be subject to annual deductibles or coinsurance.
24 § 4. This act shall take effect on the thirtieth day after it shall
25 have become a law, and shall apply to policies and contracts issued,
26 renewed, modified, altered or amended on or after such effective date.
