Connecticut 2019 Regular Session

Connecticut House Bill HB07124 Compare Versions

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Version 2 (New)

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	3	+	LCO No. 4014 1 of 4
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7		-	General Assembly ~~Substitute~~ Bill No. 7124
	5	+	General Assembly Raised Bill No. 7124
8	6		January Session, 2019
	7	+	LCO No. 4014
9	8
	9	+
	10	+	Referred to Committee on INSURANCE AND REAL ESTATE
	11	+
	12	+
	13	+	Introduced by:
	14	+	(INS)
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14	19		AN ACT CONCERNING RE QUIRED HEALTH INSURANCE
15	20		COVERAGE FOR MAMMOGR AMS AND BREAST ULTRA SOUNDS.
16	21		Be it enacted by the Senate and House of Representatives in General
17	22		Assembly convened:
18	23
19	24		Section 1. Subsection (b) of section 38a-503 of the general statutes is 1
20	25		repealed and the following is substituted in lieu thereof (Effective 2
21	26		January 1, 2020): 3
22	27		(b) (1) Each individual health insurance policy providing coverage 4
23	28		of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of 5
24	29		section 38a-469 delivered, issued for delivery, renewed, amended or 6
25	30		continued in this state shall provide benefits for mammograms to any 7
26	31		woman covered under the policy that are at least equal to the 8
27	32		following minimum requirements: (A) A baseline mammogram, which 9
28	33		may be provided by breast tomosynthesis at the option of the woman 10
29		-	covered under the policy, for any woman who is thirty-five to thirty-11
30		-	nine years of age, inclusive; and (B) a mammogram, which may be 12
31		-	provided by breast tomosynthesis at the option of the woman covered 13
32		-	under the policy, every year for any woman who is forty years of age 14
33		-	or older. 15
34		-	(2) Such policy shall provide additional benefits for: 16
35		-	(A) Comprehensive ultrasound screening of an entire breast or 17
36		-	breasts if: [a] (i) A mammogram demonstrates heterogeneous or dense 18 Substitute Bill No. 7124
	34	+	covered under the policy, for any woman who is [thirty-five to thirty-11
	35	+	nine] thirty years of age [, inclusive] or older; and (B) if recommended 12
	36	+	by such woman's treating physician, a mammogram, which may be 13
	37	+	provided by breast tomosynthesis at the option of the woman covered 14
	38	+	under the policy, every year for any woman who (i) is [forty] thirty 15 Raised Bill No. 7124
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43		-	breast tissue based on the Breast Imaging Reporting and Data System 19
44		-	established by the American College of Radiology; [or if] (ii) a woman 20
45		-	is believed to be at increased risk for breast cancer due to (I) family 21
46		-	history or prior personal history of breast cancer, (II) positive genetic 22
47		-	testing, or (III) other indications as determined by a woman's physician 23
48		-	or advanced practice registered nurse; or (iii) such screening is 24
49		-	recommended by a woman's treating physician for a woman who (I) is 25
50		-	forty years of age or older, (II) has a family history or prior personal 26
51		-	history of breast cancer, or (III) has a prior personal history of breast 27
52		-	disease diagnosed through biopsy as benign; and 28
53		-	(B) Magnetic resonance imaging of an entire breast or breasts in 29
54		-	accordance with guidelines established by the American Cancer 30
55		-	Society. 31
56		-	Sec. 2. Subsection (b) of section 38a-530 of the general statutes is 32
57		-	repealed and the following is substituted in lieu thereof (Effective 33
58		-	January 1, 2020): 34
59		-	(b) (1) Each group health insurance policy providing coverage of the 35
60		-	type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-36
61		-	469 delivered, issued for delivery, renewed, amended or continued in 37
62		-	this state shall provide benefits for mammograms to any woman 38
63		-	covered under the policy that are at least equal to the following 39
64		-	minimum requirements: (A) A baseline mammogram, which may be 40
65		-	provided by breast tomosynthesis at the option of the woman covered 41
66		-	under the policy, for any woman who is thirty-five to thirty-nine years 42
67		-	of age, inclusive; and (B) a mammogram, which may be provided by 43
68		-	breast tomosynthesis at the option of the woman covered under the 44
69		-	policy, every year for any woman who is forty years of age or older. 45
70		-	(2) Such policy shall provide additional benefits for: 46
71		-	(A) Comprehensive ultrasound screening of an entire breast or 47
72		-	breasts if: [a] (i) A mammogram demonstrates heterogeneous or dense 48
73		-	breast tissue based on the Breast Imaging Reporting and Data System 49 Substitute Bill No. 7124
	42	+	LCO No. 4014 2 of 4
	43	+
	44	+	years of age or older, (ii) has a family history or prior personal history 16
	45	+	of breast cancer, or (iii) has a prior personal history of breast disease 17
	46	+	diagnosed through biopsy as benign. 18
	47	+	(2) Such policy shall provide additional benefits for: 19
	48	+	(A) Comprehensive ultrasound screening of an entire breast or 20
	49	+	breasts if: [a] (i) A mammogram demonstrates heterogeneous or dense 21
	50	+	breast tissue based on the Breast Imaging Reporting and Data System 22
	51	+	established by the American College of Radiology; [or if] (ii) a woman 23
	52	+	is believed to be at increased risk for breast cancer due to (I) family 24
	53	+	history or prior personal history of breast cancer, (II) positive genetic 25
	54	+	testing, or (III) other indications as determined by a woman's physician 26
	55	+	or advanced practice registered nurse; or (iii) such screening is 27
	56	+	recommended by a woman's treating physician for a woman who (I) is 28
	57	+	thirty years of age or older, (II) has a family history or prior personal 29
	58	+	history of breast cancer, or (III) has a prior personal history of breast 30
	59	+	disease diagnosed through biopsy as benign; and 31
	60	+	(B) Magnetic resonance imaging of an entire breast or breasts in 32
	61	+	accordance with guidelines established by the American Cancer 33
	62	+	Society. 34
	63	+	Sec. 2. Subsection (b) of section 38a-530 of the general statutes is 35
	64	+	repealed and the following is substituted in lieu thereof (Effective 36
	65	+	January 1, 2020): 37
	66	+	(b) (1) Each group health insurance policy providing coverage of the 38
	67	+	type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-39
	68	+	469 delivered, issued for delivery, renewed, amended or continued in 40
	69	+	this state shall provide benefits for mammograms to any woman 41
	70	+	covered under the policy that are at least equal to the following 42
	71	+	minimum requirements: (A) A baseline mammogram, which may be 43
	72	+	provided by breast tomosynthesis at the option of the woman covered 44
	73	+	under the policy, for any woman who is [thirty-five to thirty-nine] 45
	74	+	thirty years of age [, inclusive] or older; and (B) if recommended by 46
	75	+	such woman's treating physician, a mammogram, which may be 47 Raised Bill No. 7124
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80		-	established by the American College of Radiology; [or if] (ii) a woman 50
81		-	is believed to be at increased risk for breast cancer due to (I) family 51
82		-	history or prior personal history of breast cancer, (II) positive genetic 52
83		-	testing, or (III) other indications as determined by a woman's physician 53
84		-	or advanced practice registered nurse; or (iii) such screening is 54
85		-	recommended by a woman's treating physician for a woman who (I) is 55
86		-	forty years of age or older, (II) has a family history or prior personal 56
87		-	history of breast cancer, or (III) has a prior personal history of breast 57
88		-	disease diagnosed through biopsy as benign; and 58
89		-	(B) Magnetic resonance imaging of an entire breast or breasts in 59
90		-	accordance with guidelines established by the American Cancer 60
91		-	Society. 61
	79	+	LCO No. 4014 3 of 4
	80	+
	81	+	provided by breast tomosynthesis at the option of the woman covered 48
	82	+	under the policy, every year for any woman who (i) is [forty] thirty 49
	83	+	years of age or older, (ii) has a family history or prior personal history 50
	84	+	of breast cancer, or (iii) has a prior personal history of breast disease 51
	85	+	diagnosed through biopsy as benign. 52
	86	+	(2) Such policy shall provide additional benefits for: 53
	87	+	(A) Comprehensive ultrasound screening of an entire breast or 54
	88	+	breasts if: [a] (i) A mammogram demonstrates heterogeneous or dense 55
	89	+	breast tissue based on the Breast Imaging Reporting and Data System 56
	90	+	established by the American College of Radiology; [or if] (ii) a woman 57
	91	+	is believed to be at increased risk for breast cancer due to (I) family 58
	92	+	history or prior personal history of breast cancer, (II) positive genetic 59
	93	+	testing, or (III) other indications as determined by a woman's physician 60
	94	+	or advanced practice registered nurse; or (iii) such screening is 61
	95	+	recommended by a woman's treating physician for a woman who (I) is 62
	96	+	thirty years of age or older, (II) has a family history or prior personal 63
	97	+	history of breast cancer, or (III) has a prior personal history of breast 64
	98	+	disease diagnosed through biopsy as benign; and 65
	99	+	(B) Magnetic resonance imaging of an entire breast or breasts in 66
	100	+	accordance with guidelines established by the American Cancer 67
	101	+	Society. 68
92	102		This act shall take effect as follows and shall amend the following
93	103		sections:
94	104
95	105		Section 1 January 1, 2020 38a-503(b)
96	106		Sec. 2 January 1, 2020 38a-530(b)
97	107
98		-	INS Joint Favorable Subst.
	108	+	Statement of Purpose:
	109	+	To require health insurance coverage for (1) a baseline mammogram
	110	+	for any woman who is thirty years of age or older, (2) an annual
	111	+	mammogram for any woman who receives a recommendation from
	112	+	such woman's treating physician and (A) is thirty years of age or older,
	113	+	(B) has a family history or prior personal history of breast cancer, or
	114	+	(C) has a prior personal history of breast disease diagnosed through Raised Bill No. 7124
	115	+
	116	+
	117	+
	118	+	LCO No. 4014 4 of 4
	119	+
	120	+	biopsy as benign, and (3) comprehensive breast ultrasound screening
	121	+	for any woman who receives a recommendation from such woman's
	122	+	treating physician and (A) is thirty years of age or older, (B) has a
	123	+	family history or prior personal history of breast cancer, or (C) has a
	124	+	prior personal history of breast disease diagnosed through biopsy as
	125	+	benign.
	126	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
	127	+	except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
	128	+	not underlined.]
99	129