"Michelle's Law"; requires health benefit plans to cover mammogram for an individual if recommended by health care provider.
Impact
If enacted, A3053 would significantly alter existing health insurance laws in New Jersey, specifically those governing breast cancer screening. The bill amends previous legislations such as P.L.1991, c.279 and P.L.2004, c.86, ensuring that all health insurance plans are required to provide comprehensive mammography coverage. This will include baseline and annual mammograms for women 40 years and older and allow for further evaluations like ultrasounds or MRIs when indicated by prior mammography results or patient risk factors. By broadening eligibility, it aims to encourage more proactive preventive care, potentially leading to earlier detection of breast cancer among younger women.
Summary
Assembly Bill A3053, also known as 'Michelle's Law,' proposes the expansion of health benefit coverage for mammograms. This law mandates that all health benefit plans in New Jersey must cover the cost of a mammogram if it is recommended by a healthcare provider, extending coverage to younger women who may not currently qualify under existing laws. Traditionally, insurance coverage for mammograms has largely been limited to women age 40 and over or those under 40 with specific risk factors such as family history. The law aims to address health disparities by providing necessary screenings to women at risk of breast cancer regardless of age, contingent on their healthcare provider's recommendation.
Contention
There may be contention surrounding the financial implications of this law for insurance providers, as extending coverage could lead to increased costs. While advocates contend that improving access to mammograms could ultimately save lives and reduce long-term expenses related to advanced cancer treatment, opponents may argue about the potential for increased premiums or the burden on insurance companies. Discussions also center on whether the amendments may require further oversight regarding what constitutes 'medical necessity' for younger women. Balancing comprehensive benefits with sustainable healthcare costs will be a critical part of the legislative discourse surrounding A3053.
Requires health care professionals to order bi-lateral ultrasounds concurrently when ordering mammograms; requires insurers to cover concurrent mammograms and bi-lateral ultrasounds.
Requires health care professionals to order bi-lateral ultrasounds concurrently when ordering mammograms; requires insurers to cover concurrent mammograms and bi-lateral ultrasounds.
Requires health care professional to order bi-lateral ultrasounds concurrently when ordering mammograms; requires insurers to cover concurrent mammograms and bi-lateral ultrasounds.
Requires health care professionals to order bi-lateral ultrasounds concurrently when ordering mammograms; requires insurers to cover concurrent mammograms and bi-lateral ultrasounds.
Requires health care professionals to order bi-lateral ultrasounds concurrently when ordering mammograms; requires insurers to cover concurrent mammograms and bi-lateral ultrasounds.
Requires health care professional to order bi-lateral ultrasounds concurrently when ordering mammograms; requires insurers to cover concurrent mammograms and bi-lateral ultrasounds.
Requires health care professionals to order bi-lateral ultrasounds concurrently when ordering mammograms; requires insurers to cover concurrent mammograms and bilateral ultrasounds.