STATE OF NEW YORK
________________________________________________________________________
5677
2017-2018 Regular Sessions
IN ASSEMBLY
February 14, 2017
___________
Introduced by M. of A. SEAWRIGHT, BRINDISI -- read once and referred to
the Committee on Insurance
AN ACT to amend the insurance law, in relation to health insurance
coverage for mammography by breast tomosynthesis
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subparagraphs (A) and (C) of paragraph (11) of subsection
2 (i) of section 3216 of the insurance law, as amended by chapter 219 of
3 the laws of 2011, are amended to read as follows:
4 (A) Every policy that provides coverage for hospital, surgical or
5 medical care shall provide the following coverage for mammography
6 screening for occult breast cancer:
7 (i) upon the recommendation of a physician, a mammogram, which may be
8 provided by breast tomosynthesis, at any age for covered persons having
9 a prior history of breast cancer or who have a first degree relative
10 with a prior history of breast cancer;
11 (ii) a single baseline mammogram, which may be provided by breast
12 tomosynthesis, for covered persons aged thirty-five through thirty-nine,
13 inclusive; and
14 (iii) an annual mammogram, which may be provided by breast tomosynthe-
15 sis, for covered persons aged forty and older.
16 (C) For purposes of subparagraphs (A) and (B) of this paragraph,
17 mammography screening means an X-ray examination of the breast using
18 dedicated equipment, including X-ray tube, filter, compression device,
19 screens, films and cassettes, with an average glandular radiation dose
20 less than 0.5 rem per view per breast; provided, however, that mammogra-
21 phy screening shall also include breast tomosynthesis.
22 § 2. Subparagraphs (A) and (C) of paragraph (11) of subsection (l) of
23 section 3221 of the insurance law, as amended by chapter 219 of the laws
24 of 2011, are amended to read as follows:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07634-01-7
A. 5677 2
1 (A) Every insurer delivering a group or blanket policy or issuing a
2 group or blanket policy for delivery in this state that provides cover-
3 age for hospital, surgical or medical care shall provide the following
4 coverage for mammography screening for occult breast cancer:
5 (i) upon the recommendation of a physician, a mammogram, which may be
6 provided by breast tomosynthesis, at any age for covered persons having
7 a prior history of breast cancer or who have a first degree relative
8 with a prior history of breast cancer;
9 (ii) a single baseline mammogram, which may be provided by breast
10 tomosynthesis, for covered persons aged thirty-five through thirty-nine,
11 inclusive; and
12 (iii) an annual mammogram, which may be provided by breast tomosynthe-
13 sis, for covered persons aged forty and older.
14 (C) For purposes of subparagraphs (A) and (B) of this paragraph,
15 mammography screening means an X-ray examination of the breast using
16 dedicated equipment, including X-ray tube, filter, compression device,
17 screens, films and cassettes, with an average glandular radiation dose
18 less than 0.5 rem per view per breast; provided, however, that mammogra-
19 phy screening shall also include breast tomosynthesis.
20 § 3. Subparagraphs (A), (B) and (C) of paragraph (1) of subsection (p)
21 of section 4303 of the insurance law, as amended by chapter 219 of the
22 laws of 2011, are amended to read as follows:
23 (A) upon the recommendation of a physician, a mammogram, which may be
24 provided by breast tomosynthesis, at any age for covered persons having
25 a prior history of breast cancer or who have a first degree relative
26 with a prior history of breast cancer;
27 (B) a single baseline mammogram, which may be provided by breast tomo-
28 synthesis, for covered persons aged thirty-five through thirty-nine,
29 inclusive; and
30 (C) an annual mammogram, which may be provided by breast tomosythesis,
31 for covered persons aged forty and older.
32 § 4. Paragraph (2) of subsection (p) of section 4303 of the insurance
33 law, as amended by chapter 219 of the laws of 2011, is amended to read
34 as follows:
35 (2) For purposes of paragraph one of this subsection, mammography
36 screening means an X-ray examination of the breast using dedicated
37 equipment, including X-ray tube, filter, compression device, screens,
38 films and cassettes, with an average glandular radiation dose less than
39 0.5 rem per view per breast; provided, however, that mammography screen-
40 ing shall also include breast tomosythesis.
41 § 5. This act shall take effect on the sixtieth day after it shall
42 have become a law and shall apply to all policies and contracts issued,
43 renewed, modified, altered or amended on or after such date.