Connecticut 2011 Regular Session

Connecticut Senate Bill SB00848 Compare Versions

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11 General Assembly Raised Bill No. 848
22 January Session, 2011 LCO No. 2314
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44 Referred to Committee on Insurance and Real Estate
55 Introduced by:
66 (INS)
77
88 General Assembly
99
1010 Raised Bill No. 848
1111
1212 January Session, 2011
1313
1414 LCO No. 2314
1515
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16+*02314_______INS*
1717
1818 Referred to Committee on Insurance and Real Estate
1919
2020 Introduced by:
2121
2222 (INS)
2323
2424 AN ACT CONCERNING BREAST ULTRASOUND SCREENINGS.
2525
2626 Be it enacted by the Senate and House of Representatives in General Assembly convened:
2727
2828 Section 1. Section 38a-503 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2012):
2929
3030 (a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), [(6),] (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state [on or after October 1, 2001,] shall provide benefits for mammographic examinations to any woman covered under the policy which are at least equal to the following minimum requirements: (1) A baseline mammogram for any woman who is thirty-five to thirty-nine years of age, inclusive; and (2) a mammogram every year for any woman who is forty years of age or older.
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3232 (b) Such policy shall:
3333
3434 [provide] (1) Provide additional benefits for comprehensive ultrasound screening of an entire breast or breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast Imaging Reporting and Data System established by the American College of Radiology or if a woman is believed to be at increased risk for breast cancer due to family history or prior personal history of breast cancer, positive genetic testing or other indications as determined by a woman's physician or advanced practice registered nurse; and
3535
3636 (2) Not impose a coinsurance, copayment, deductible or other out-of-pocket expense for such ultrasound screening, except that a high deductible health plan, as that term is used in subsection (f) of section 38a-493, shall not be subject to this subdivision.
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3838 [(b) Benefits] (c) Except as specified under subdivision (2) of subsection (b) of this section, benefits under this section shall be subject to any policy provisions that apply to other services covered by such policy.
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4040 [(c)] (d) On and after October 1, 2009, each mammography report provided to a patient shall include information about breast density, based on the Breast Imaging Reporting and Data System established by the American College of Radiology. Where applicable, such report shall include the following notice: "If your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary screening tests, which can include a breast ultrasound screening or a breast MRI examination, or both, depending on your individual risk factors. A report of your mammography results, which contains information about your breast density, has been sent to your physician's office and you should contact your physician if you have any questions or concerns about this report.".
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4242 Sec. 2. Section 38a-530 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2012):
4343
4444 (a) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state [on or after October 1, 2001,] shall provide benefits for mammographic examinations to any woman covered under the policy which are at least equal to the following minimum requirements: (1) A baseline mammogram for any woman who is thirty-five to thirty-nine years of age, inclusive; and (2) a mammogram every year for any woman who is forty years of age or older.
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4646 (b) Such policy shall:
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4848 [provide] (1) Provide additional benefits for comprehensive ultrasound screening of an entire breast or breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast Imaging Reporting and Data System established by the American College of Radiology or if a woman is believed to be at increased risk for breast cancer due to family history or prior personal history of breast cancer, positive genetic testing or other indications as determined by a woman's physician or advanced practice registered nurse; and
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5050 (2) Not impose a coinsurance, copayment, deductible or other out-of-pocket expense for such ultrasound screening, except that a high deductible health plan, as that term is used in subsection (f) of section 38a-520, shall not be subject to this subdivision.
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5252 [(b) Benefits] (c) Except as specified under subdivision (2) of subsection (b) of this section, benefits under this section shall be subject to any policy provisions that apply to other services covered by such policy.
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5454 [(c)] (d) On and after October 1, 2009, each mammography report provided to a patient shall include information about breast density, based on the Breast Imaging Reporting and Data System established by the American College of Radiology. Where applicable, such report shall include the following notice: "If your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary screening tests, which can include a breast ultrasound screening or a breast MRI examination, or both, depending on your individual risk factors. A report of your mammography results, which contains information about your breast density, has been sent to your physician's office and you should contact your physician if you have any questions or concerns about this report.".
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5656
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5959 This act shall take effect as follows and shall amend the following sections:
6060 Section 1 January 1, 2012 38a-503
6161 Sec. 2 January 1, 2012 38a-530
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6363 This act shall take effect as follows and shall amend the following sections:
6464
6565 Section 1
6666
6767 January 1, 2012
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6969 38a-503
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7171 Sec. 2
7272
7373 January 1, 2012
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7575 38a-530
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77+Statement of Purpose:
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79+To prohibit insurers from imposing a coinsurance, copayment, deductible or other out-of-pocket expense on an insured for breast ultrasound screening.
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79-INS Joint Favorable
80-
81-INS
82-
83-Joint Favorable
81+[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]