New York State Assembly

 
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A05677 Summary:

A05677 Actions:

A05677 Committee Votes:

Committee:INSURANCE   Chair:Cahill      
DATE:03/07/2017AYE/NAY:25/0  Action: Favorable refer to committee Codes        
Cahill
Aye
Barclay
Aye
Cook
Aye
Butler
Aye
Pretlow
Aye
Hawley
Aye
Rivera
Aye
Blankenbush
Aye
Peoples-Stokes
Aye
Curran
Aye
Cymbrowitz
Aye
Walter
Aye
Lavine
Aye
Garbarino
Aye
Moya
Aye
Hevesi
Aye
Skoufis
Aye
Steck
Aye
Crespo
Aye
Joyner
Aye
Dilan
Aye
Hunter
Aye
Simotas
Aye
Walker
Aye
Niou
Aye

Committee:CODES   Chair:Lentol      
DATE:03/13/2017AYE/NAY:20/0  Action: Favorable         
Lentol
Aye
Graf
Aye
Schimminger
Aye
Giglio
Aye
Weinstein
Aye
McKevitt
Aye
Pretlow
Aye
Montesano
Aye
Cook
Aye
Ra
Aye
Cymbrowitz
Aye
Morinello
Aye
Titus
Absent
O'Donnell
Aye
Lavine
Aye
Perry
Aye
Zebrowski
Aye
Abinanti
Aye
Weprin
Aye
Mosley
Aye
Hevesi
Excused
Fahy
Aye

A05677 Floor Votes:

A05677 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
 submitted in accordance with Assembly Rule III, Sec 1(f)



 
BILL NUMBER: A5677
 
SPONSOR: Seawright

 
TITLE OF BILL:  An act to amend the insurance law, in relation to
health insurance coverage for mammography by breast tomosynthesis
 
 
PURPOSE:
 
To require breast tomosyntheis (3-1) mammography) to covered by insur-
ance companies in New York State.
 
 
SUMMARY OF PROVISIONS:
 
Section 1 states that every policy providing coverage for hospital,
surgical or medical care shall include coverage for breast tomosynthesis
for mammography screening for occult breast cancer.

Section 2 stipulates that every insurer delivering a group or blanket
policy or issuing a group or blanket policy for delivery in this state
that provides coverage for hospital, surgical or medical care shall
include coverage for breast tomosynthesis for mammography screening for
occult breast cancer. Subparagraph (C) includes breast tomosynthesis in
the definition of mammography screening.
 
Section 3. Subparagraph (A) mandates breast tomosynthesis as an accepta-
ble form of breast cancer screening that is to be covered by insurance
plans for covered persons of any age who either have a prior history of
breast cancer or who have a first degree relative with a prior history
of breast cancer. Subparagraph (B) allows for breast tomosynthesis to be
utilized as a baseline mammography for covered persons aged thirty-five
through thirty-nine, and that it should be covered by the individual's
provider. Subparagraph (C) mandates annual mammograms for covered
persons forty and over shall have any breast tomosynthesis scan covered
by their provider.
 
Section 4 amends paragraph (2) of subsection (p) of section 4303 of the
insurance law to include breast tomosynthesis in its definition of
mammography.
 
Section 5 is the effective date.
 
 
JUSTIFICATION:
 
Tomosynthesis, or 3-D mammography, has proven to be a more consistent
and reliable way of detecting breast cancer. This type of breast cancer
screening has proven to be able to detect breast cancer earlier than
traditional mammography, as well as reduce the incidence of false-posi-
tives.
 
Unfortunately, most insurers do not cover breast tomosynthesis. This
bill would mandate that insurers provide this coverage to women who opt
to take advantage of this technology.
 
 
LEGISLATIVE HISTORY:
 
New Bill.
 
 
EFFECTIVE DATE:
This bill shall take effect on the sixtieth day after it shall have
become a law.

A05677 Text:

 
                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.