HASBSB119 TYLERT 2356
SENATE SUMMARY OF HOUSE AMENDMENTS
SB 119 2021 Regular Session Tarver
KEYWORD AND SUMMARY AS RETURNED TO THE SENATE
HEALTH/ACC INSURANCE. Provides relative to health insurance coverage for
mammography. (1/1/22)
SUMMARY OF HOUSE AMENDMENTS TO THE SENATE BILL
1. Adds requirement that single baseline mammograms for women 35-39 and
certain annual MRIs and mammography for women with certain hereditary
susceptibilities to be in accordance with recommendations and guidelines by
the National Comprehensive Cancer Network or the American Society of
Breast Surgeons Position Statement on Screening Mammography no later
than the following policy or plan year following changes in
recommendations.
2. Adds provision relative to access to women age 35 having a predicted
lifetime risk that is greater than 20% by any validated model published in
peer review medical literature.
3. Adds provisions that a breast ultrasound is the initial preferred modality,
followed by an MRI if the ultrasound is inconclusive, with respect to
supplemental imaging.
4. Provides that coverage pertaining to early screening and detection may be
subject to the health coverage plan's utilization review using guidelines
published in peer reviewed medical literature.
5. Requires any policy, contract, or health coverage plan in effect prior to
January 1, 2022, to conform to the provisions of proposed law on or before
the renewal its date, but no later than January 1, 2023.
DIGEST OF THE SENATE BILL AS RETURNED TO THE SENATE
SB 119 Engrossed 2021 Regular Session Tarver
Present law requires that health coverage plans which are delivered or issued for delivery
in this state include benefits payable for an annual Pap test and minimum mammography
examination.
Present law defines "minimum mammography examination" as mammographic
examinations, including but not limited to digital breast tomosynthesis, performed no less
frequently than the following schedule provides:
(1)One baseline mammogram for any woman who is 35-39 years of age.
(2)One mammogram every 24 months for any woman who is 40-49 years of age, or
more frequently if recommended by her physician.
(3)One mammogram every 12 months for any woman who is 50 years of age or older.
Proposed law retains the schedule and provides for earlier screening based on certain criteria
of the American Society of Breast Surgeons as follows:
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(1)(a)Regarding the single baseline mammogram for women 35-39, provides for
annual MRI starting at age 25 and annual mammography starting at age 30,
if there is a hereditary susceptibility from pathogenic mutation carrier status
or prior chest wall radiation. Requires that the examinations to be in
accordance with recommendations by the National Comprehensive Cancer
Network guidelines or the American Society of Breast Surgeons Position
Statement on Screening Mammography no later than the following policy or
plan year following changes in recommendations.
(b)Provides for annual mammography (DBT preferred modality) and access to
supplemental imaging (MRI preferred modality) starting at age 35 if
recommended by the woman's physician and the woman has a predicted
lifetime risk greater than 20% by any validated model published in peer
reviewed medical literature.
(2)Annual mammography (DBT preferred modality) for any woman who is 40 years of
age or older.
(a)Consideration given to supplemental imaging, (breast ultrasound initial
preferred modality, followed by MRI is inconclusive), if recommended by
her physician, for women with increased breast density (C and D density).
(b)Access to annual supplemental imaging (MRI preferred modality), if
recommended by her physician, for women with a prior history of breast
cancer below the age of 50 or with a prior history of breast cancer at any age
and dense breast (C and D density).
Proposed law provides that coverage pertaining to present and proposed law (R.S. 22:1028)
regarding early screening and detection may be subject to the health coverage plan's
utilization review using guidelines published in peer reviewed medical literature.
Proposed law requires a policy, contract, or health coverage plan in effect prior to January
1, 2022 to convert to the provisions of proposed law no later than by January 1, 2023.
Effective January 1, 2022.
(Amend R.S. 22:1028(A)(2))
______________________
Thomas L. Tyler
Deputy Chief of Staff
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