Provides that individuals may receive breast cancer screenings under an insurance plan when such individual has a second degree relative with a prior history of breast cancer.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A8387
SPONSOR: Seawright
 
TITLE OF BILL:
An act to amend the insurance law, in relation to including second
degree relatives in certain criteria for breast cancer screenings to be
covered under insurance plans
 
PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this bill is to expand eligibility for breast cancer
screening to individuals with a second degree relative with a prior
history of breast cancer.
 
SUMMARY OF PROVISIONS:
Section 1 of this bill would require that every. person insured under an
individual policy of accident and health insurance delivered or issued
for delivery in this state shall be eligible, upon the recommendation of
a physician and who has a second degree relative with a prior history of
breast cancer, for a mammogram at any age.
Section 2 of this bill would require that every person insured under a
group or blanket policy of accident and health insurance delivered or
issued for delivery in this state shall be eligible, upon the recommen-
dation of a physician and who has a second degree relative with a prier
history of breast cancer, fora mammogram at any age.
Section 3 of this bill would require that a medical expense indemnity
corporation, a hospital service corporation or a health service corpo-
ration that provides coverage for hospital, surgical or medical care
shall provide coverage for mammography screening for occult breast
cancer at any age for covered persons upon the recommendation of a
physician and who has a second degree relative with a prior history of
breast cancer
Section 4 of this bill provides that the effective date shall take
effect on the sixtieth day after it shall have become a-law and shall
apply to all policies and contracts issued, renewed, modified, altered
or amended on or after such date.
 
JUSTIFICATION:
Current law, enacted in 1988 and 1989, stipulates that insurance poli-
cies covering hospital, surgical, and medical care must cover mammogra-
phy examinations to detect breast cancer in policyholders over a certain
age, under certain medical conditions, and with a family history of
breast cancer. Mammography screening is recognized as the most effective
means of detecting breast cancer in its early. Stages, when prospects
for treatment and recovery are greatest. Chapter 692 of the Laws of 1988
and Chapter 417 of the Laws of 1989 were important first steps in ensur-
ing the regular, healthy screening of residents and requiring policy
coverage of critical preventative care. However, medical professionals
have continued to call for increased regular screening for policyholders
under age fifty and for those with greater risks, such as a family
history of breast cancer.
Furthermore, limiting mammography options to the first degree relative
prevents access to some policyholders; for example, if a parent of such
policyholder dies prior to receiving a breast cancer screening in a
family with a known history of breast cancer. In this situation, if such
policyholder had a second degree relative with breast cancer, they may
not be able to utilize care services simply by the happenstance of an
untimely death. Greater access to this essential early detection test
would provide policyholders with better health outcomes. This bill would
expand eligibility for breast cancer screening to individuals with a
second degree relative with a prior history of breast cancer.
 
PRIOR LEGISLATIVE HISTORY:
This is a new bill.
 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
None to the State.
 
EFFECTIVE DATE:
This act shall take effect on the sixtieth day after it shall have
become a law and shall apply to all policies and contracts issued,
renewed, modified, altered or amended on or after such date.
STATE OF NEW YORK
________________________________________________________________________
8387
2023-2024 Regular Sessions
IN ASSEMBLY
December 13, 2023
___________
Introduced by M. of A. SEAWRIGHT -- read once and referred to the
Committee on Insurance
AN ACT to amend the insurance law, in relation to including second
degree relatives in certain criteria for breast cancer screenings to
be covered under insurance plans
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Item (i) of subparagraph (A) of paragraph 11 of subsection
2 (i) of section 3216 of the insurance law, as amended by chapter 414 of
3 the laws of 2017, is amended to read as follows:
4 (i) upon the recommendation of a physician, a mammogram, which may be
5 provided by breast tomosynthesis, at any age for covered persons having
6 a prior history of breast cancer or who have a first or second degree
7 relative with a prior history of breast cancer;
8 § 2. Item (i) of subparagraph (A) of paragraph 11 of subsection (l) of
9 section 3221 of the insurance law, as amended by chapter 143 of the laws
10 of 2019, is amended to read as follows:
11 (i) upon the recommendation of a physician, a mammogram, which may be
12 provided by breast tomosynthesis, at any age for covered persons having
13 a prior history of breast cancer or who have a first or second degree
14 relative with a prior history of breast cancer;
15 § 3. Subparagraph (A) of paragraph 1 of subsection (p) of section 4303
16 of the insurance law, as amended by chapter 414 of the laws of 2017, is
17 amended to read as follows:
18 (A) upon the recommendation of a physician, a mammogram, which may be
19 provided by breast tomosynthesis, at any age for covered persons having
20 a prior history of breast cancer or who have a first or second degree
21 relative with a prior history of breast cancer;
22 § 4. This act shall take effect on the sixtieth day after it shall
23 have become a law and shall apply to all policies and contracts issued,
24 renewed, modified, altered or amended on or after such date.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD13430-01-3