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.
