General Assembly Raised Bill No. 811
January Session, 2013 LCO No. 2515
*02515_______INS*
Referred to Committee on INSURANCE AND REAL ESTATE
Introduced by:
(INS)
General Assembly
Raised Bill No. 811
January Session, 2013
LCO No. 2515
*02515_______INS*
Referred to Committee on INSURANCE AND REAL ESTATE
Introduced by:
(INS)
AN ACT CONCERNING HEALTH INSURANCE COVERAGE OF A SECOND MAMMOGRAM.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Subsection (a) of section 38a-503 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2014):
(a) (1) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide benefits for mammographic examinations to any woman covered under the policy that are at least equal to the following minimum requirements: (A) A baseline mammogram for any woman who is thirty-five to thirty-nine years of age, inclusive; and (B) a mammogram every year for any woman who is forty years of age or older.
(2) Such policy shall provide additional benefits for:
(A) 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;
(B) A second mammogram in a policy year of an entire breast or breasts if the first mammogram demonstrates heterogeneous or dense breast tissue based on the Breast Imaging Reporting and Data System established by the American College of Radiology and such second mammogram is ordered by a woman's physician; and
[(B)] (C) Magnetic resonance imaging of an entire breast or breasts in accordance with guidelines established by the American Cancer Society.
Sec. 2. Section (a) of section 38a-530 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2014):
(a) (1) 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 shall provide benefits for mammographic examinations to any woman covered under the policy that are at least equal to the following minimum requirements: (A) A baseline mammogram for any woman who is thirty-five to thirty-nine years of age, inclusive; and (B) a mammogram every year for any woman who is forty years of age or older.
(2) Such policy shall provide additional benefits for:
(A) 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;
(B) A second mammogram in a policy year of an entire breast or breasts if the first mammogram demonstrates heterogeneous or dense breast tissue based on the Breast Imaging Reporting and Data System established by the American College of Radiology and such second mammogram is ordered by a woman's physician; and
[(B)] (C) Magnetic resonance imaging of an entire breast or breasts in accordance with guidelines established by the American Cancer Society.
This act shall take effect as follows and shall amend the following sections:
Section 1 January 1, 2014 38a-503(a)
Sec. 2 January 1, 2014 38a-530(a)
This act shall take effect as follows and shall amend the following sections:
Section 1
January 1, 2014
38a-503(a)
Sec. 2
January 1, 2014
38a-530(a)
Statement of Purpose:
To require health insurance policies to provide coverage of a second mammogram in a policy year if the first mammogram demonstrates heterogeneous or dense breast tissue and the woman's physician orders a second mammogram.
[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.]