Enacts "Shannon's law"; relates to requiring insurance companies to cover annual mammograms for breast cancer screening for covered persons aged thirty-five and older.
STATE OF NEW YORK
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5502--A
2019-2020 Regular Sessions
IN ASSEMBLY
February 13, 2019
___________
Introduced by M. of A. JEAN-PIERRE, COOK, WALKER, COLTON, JAFFEE, HYND-
MAN, DICKENS, ZEBROWSKI, SIMON, D'URSO, ROZIC, ABINANTI, BLAKE, McDO-
NOUGH, M. L. MILLER, PALUMBO, WRIGHT, JOYNER, BRABENEC, GARBARINO,
LiPETRI, TITUS, RAIA -- Multi-Sponsored by -- M. of A. THIELE -- read
once and referred to the Committee on Insurance -- reported and
referred to the Committee on Codes -- reported and referred to the
Committee on Ways and Means -- committee discharged, bill amended,
ordered reprinted as amended and recommitted to said committee
AN ACT to amend the insurance law, in relation to enacting "Shannon's
Law"
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Short title. This act shall be known and may be cited as
2 "Shannon's Law".
3 § 2. Subparagraph (A) of paragraph 11 of subsection (l) of section
4 3221 of the insurance law, as amended by chapter 414 of the laws of
5 2017, is amended to read as follows:
6 (A) Every insurer delivering a group or blanket policy or issuing a
7 group or blanket policy for delivery in this state that provides cover-
8 age for hospital, surgical or medical care shall provide the following
9 coverage for mammography screening for occult breast cancer:
10 (i) upon the recommendation of a physician, a mammogram, which may be
11 provided by breast tomosynthesis, at any age for covered persons having
12 a prior history of breast cancer or who have a first degree relative
13 with a prior history of breast cancer;
14 (ii) a single baseline mammogram, which may be provided by breast
15 tomosynthesis, for covered persons aged thirty-five through thirty-nine,
16 inclusive; [and]
17 (iii) an annual mammogram, which may be provided by breast tomosynthe-
18 sis, for covered persons aged forty and older[.]; and
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD09044-03-9
A. 5502--A 2
1 (iv) for large group policies that provide coverage for hospital,
2 surgical or medical care, an annual mammogram for covered persons aged
3 thirty-five through thirty-nine, inclusive, upon the recommendation of a
4 physician, subject to the insurer's determination that the mammogram is
5 medically necessary.
6 § 3. Subparagraphs (B), (C) and (D) of paragraph 1 of subsection (p)
7 of section 4303 of the insurance law, subparagraphs (B) and (C) as
8 amended by chapter 414 of the laws of 2017, subparagraph (D) as amended
9 by chapter 74 of the laws of 2016, are amended to read as follows:
10 (B) a single baseline mammogram, which may be provided by breast tomo-
11 synthesis, for covered persons aged thirty-five through thirty-nine,
12 inclusive; [and]
13 (C) an annual mammogram, which may be provided by breast tomosythesis,
14 for covered persons aged forty and older[.];
15 (D) for large group contracts offered by a medical expense indemnity
16 corporation, a hospital service corporation or a health service corpo-
17 ration that provide coverage for hospital, surgical or medical care, an
18 annual mammogram for covered persons aged thirty-five through thirty-
19 nine, inclusive, upon the recommendation of a physician, subject to the
20 corporation's determination that the mammogram is medically necessary;
21 and
22 (E) The coverage required in this paragraph or paragraph two of this
23 subsection shall not be subject to annual deductibles or coinsurance.
24 § 4. This act shall take effect on the thirtieth day after it shall
25 have become a law, and shall apply to policies and contracts issued,
26 renewed, modified, altered or amended on or after such effective date.
