Amd SS3216, 3221 & 4303, Ins L; amd S2404-c, Pub Health L
Relates to coverage for mammography and other image screening for occult breast cancer and providing notification of test results to patient's physician.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A8319
SPONSOR: Jaffee TITLE OF BILL: An act to amend the insurance law and the public
health law, in relation to authorizing coverage for mammography and
other imaging screening for occult breast cancer and to provide notifi-
cation of dense breast tissue results to the patient's physician
PURPOSE OR GENERAL IDEA OF BILL: To improve early breast cancer
detection by providing health insurance coverage for supplemental
screenings tests for breast cancer when mammography indicates dense
breast tissue.
SUMMARY OF SPECIFIC PROVISIONS: This bill amends Sections 3216, 3221,
and 4303 of the Insurance Law to require New York State health insurance
policies to cover supplemental screening tests for breast cancer using
other imagining modalities as deemed appropriate by the American College
of Radiology or the American Cancer Society if a mammogram demonstrates
that a covered person.has dense breast tissue or a physician determines
that a covered person has an increased risk of developing breast cancer.
For the purposes of this bill dense breast tissue means heterogeneously
dense or extremely dense tissue as defined in nationally recognized
guidelines or systems for breast imaging reporting of mammography
screening, including, but not limited to, the breast imaging reporting
and data system of the American College of Radiology, and any equivalent
new terms, as such guidelines or systems are updated.
The bill also requires that coverage of comprehensive breast ultrasound
screenings not be subject to annual deductibles or coinsurance if a
mammogram demonstrates that a woman has dense breast tissue or a physi-
cian determines that a woman has an increased risk of developing breast
cancer.
In addition, the bill amends Section 2404-c of the Public Health Law to
require providers of mammography services to send the same written
notification informing patients that they have dense breast tissue to
the patient's physician.
JUSTIFICATION: Breast cancer is one of the most common cancers and the
second leading cause or cancer-related deaths among women in New York
State. Each year in New York, over 14,000 women are diagnosed with
breast cancer and almost 2,700 women die from the disease.
In 2012, the Breast Density Inform Law was enacted in New York to help
improve early breast cancer detection and prevention by requiting
mammography providers to inform a woman if dense breast tissue is found
during an exam. Dense breast tissue makes cancer very difficult to spot
on a mammogram and raises a woman's risk of developing breast cancer.
Studies indicate that mammography will miss more than 50 percent of
cancers growing in the densest breasts because dense breast tissue and
cancer both appear white on a mammogram, making tumors hard to see.
Breast density not only dramatically compromises the effectiveness of a
mammogram, but in and of itself is considered to be an independent risk
factor for developing breast cancer. According to the American Cancer
Society, breast density is a greater relative risk factor for breast
cancer than having two first-degree relatives with the disease. The new
law raises a woman's awareness about breast density and encourages her
to have a follow-up conversation with her physician about her risks for
breast cancer and the benefit of supplemental screening.
To increase the effectiveness of the Breast Density Inform Law in New
York, this bill requires that health insurance policies cover any
supplemental screenings for breast cancer that are recommended by a
woman's physician when a mammogram indicates that a woman has dense
breasts. By ensuring women with dense breasts can afford supplemental
screenings for breast cancer, this bill will help to increase the
detection of early stage cancer and save women's lives.
PRIOR LEGISLATIVE HISTORY: New bill.
FISCAL IMPLICATIONS: To be determined.
EFFECTIVE DATE: The bill takes effect on the one hundred eightieth day
after it becomes a law.
