Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H1115 Compare Versions

Only one version of the bill is available at this time.

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1	1	1 of 1
2	2	HOUSE DOCKET, NO. 2617 FILED ON: 1/19/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 1115
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Edward R. Philips and Jessica Ann Giannino
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to the diagnosis and treatment of breast cancer.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:Edward R. Philips8th Norfolk1/19/2023Jessica Ann Giannino16th Suffolk1/19/2023Antonio F. D. Cabral13th Bristol2/3/2023Sean Garballey23rd Middlesex2/3/2023Lindsay N. Sabadosa1st Hampshire2/3/2023Samantha Montaño15th Suffolk2/16/2023Paul McMurtry11th Norfolk2/16/2023 1 of 8
16	16	HOUSE DOCKET, NO. 2617 FILED ON: 1/19/2023
17	17	HOUSE . . . . . . . . . . . . . . . No. 1115
18	18	By Representatives Philips of Sharon and Giannino of Revere, a petition (accompanied by bill,
19	19	House, No. 1115) of Edward R. Philips, Jessica Ann Giannino and others relative to healthcare
20	20	coverage for the diagnosis and treatment of breast cancer. Financial Services.
21	21	[SIMILAR MATTER FILED IN PREVIOUS SESSION
22	22	SEE HOUSE, NO. 1175 OF 2021-2022.]
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Third General Court
26	26	(2023-2024)
27	27	_______________
28	28	An Act relative to the diagnosis and treatment of breast cancer.
29	29	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
30	30	of the same, as follows:
31	31	1 SECTION 1: Section 47G of Chapter 175 of the General Laws, as appearing in the 2012
32	32	2Official Edition, is hereby amended, in line 20, by striking the language after the word
33	33	3“examination” and inserting in place thereof the following language:-
34	34	4 (1) said benefits shall provide: (i) for a baseline mammogram, which may include
35	35	5tomosynthesis, for women between the ages of thirty-five and forty and for a mammogram on an
36	36	6annual basis, which may include tomosynthesis, for women forty years of age or older; (ii) in the
37	37	7case of a woman under forty years of age who has a family history of breast cancer or other
38	38	8breast cancer risk factors, a mammogram examination, which may include tomosynthesis, at
39	39	9such age and intervals as deemed medically necessary by the woman’s health care provider; (iii)
40	40	10ultrasound evaluation, magnetic resonance imaging scan or additional mammography testing, 2 of 8
41	41	11which may include tmosynthesis, of an entire breast or breasts if the screening mammogram,
42	42	12screening ultrasound or MRI shows any abnormality where additional examination is deemed
43	43	13medically necessary by the radiologist or the patient’s health care provider, (iv) screening breast
44	44	14ultrasound or screening breast magnetic resonance imaging examination if the patient has
45	45	15additional risk factors for breast cancer including, but not limited to, family history, prior
46	46	16personal history of breast cancer, positive genetic testing, heterogeneously or extremely dense
47	47	17breast tissue based on the Breast Imaging Reporting and Data System established by the
48	48	18American College of Radiology, or other indications as determined by the patient’s health care
49	49	19provider, (v) for a diagnostic mammogram, which may include tomosynthesis, diagnostic breast
50	50	20ultrasound evaluation or breast magnetic resonance imaging scan if the patient has a history of
51	51	21breast cancer, (vi) for magnetic resonance imaging in place of, or in addition to, a mammogram
52	52	22when a mammogram is unable to detect cancers due to insufficient breast tissue as ordered by a
53	53	23patient’s physician. Said benefits shall be exempt from any co-payment, co-insurance, deductible
54	54	24or dollar limit provisions in a policy or contract.
55	55	25 SECTION 2: Section 110 of Chapter 175 of the General Laws, as appearing in the 2012
56	56	26Official Edition, is hereby amended, in line 322, by striking the language after the word
57	57	27“examination” and inserting in place thereof the following language:-
58	58	28 : (1) said benefits shall provide: (i) for a baseline mammogram, which may include
59	59	29tomosynthesis, for women between the ages of thirty-five and forty and for a mammogram on an
60	60	30annual basis, which may include tomosynthesis, for women forty years of age or older; (ii) in the
61	61	31case of a woman under forty years of age who has a family history of breast cancer or other
62	62	32breast cancer risk factors, a mammogram examination, which may include tomosynthesis, at
63	63	33such age and intervals as deemed medically necessary by the woman’s health care provider; (iii) 3 of 8
64	64	34ultrasound evaluation, magnetic resonance imaging scan or additional mammography testing,
65	65	35which may include tmosynthesis, of an entire breast or breasts if the screening mammogram,
66	66	36screening ultrasound or MRI shows any abnormality where additional examination is deemed
67	67	37medically necessary by the radiologist or the patient’s health care provider, (iv) screening breast
68	68	38ultrasound or screening breast magnetic resonance imaging examination if the patient has
69	69	39additional risk factors for breast cancer including, but not limited to, family history, prior
70	70	40personal history of breast cancer, positive genetic testing, heterogeneously or extremely dense
71	71	41breast tissue based on the Breast Imaging Reporting and Data System established by the
72	72	42American College of Radiology, or other indications as determined by the patient’s health care
73	73	43provider, (v) for a diagnostic mammogram, which may include tomosynthesis, diagnostic breast
74	74	44ultrasound evaluation or breast magnetic resonance imaging scan if the patient has a history of
75	75	45breast cancer, (vi) for magnetic resonance imaging in place of, or in addition to, a mammogram
76	76	46when a mammogram is unable to detect cancers due to insufficient breast tissue as ordered by a
77	77	47patient’s physician. Said benefits shall be exempt from any co-payment, co-insurance, deductible
78	78	48or dollar limit provisions in a policy or contract.
79	79	49 SECTION 3: Section 8J of Chapter 176A of the General Laws, as appearing in the 2012
80	80	50Official Edition, is hereby amended, in line 12, by striking the language after the word
81	81	51“examination” and inserting in place thereof the following language:-
82	82	52 : (1) said benefits shall provide: (i) for a baseline mammogram, which may include
83	83	53tomosynthesis, for women between the ages of thirty-five and forty and for a mammogram on an
84	84	54annual basis, which may include tomosynthesis, for women forty years of age or older; (ii) in the
85	85	55case of a woman under forty years of age who has a family history of breast cancer or other
86	86	56breast cancer risk factors, a mammogram examination, which may include tomosynthesis, at 4 of 8
87	87	57such age and intervals as deemed medically necessary by the woman’s health care provider; (iii)
88	88	58ultrasound evaluation, magnetic resonance imaging scan or additional mammography testing,
89	89	59which may include tmosynthesis, of an entire breast or breasts if the screening mammogram,
90	90	60screening ultrasound or MRI shows any abnormality where additional examination is deemed
91	91	61medically necessary by the radiologist or the patient’s health care provider, (iv) screening breast
92	92	62ultrasound or screening breast magnetic resonance imaging examination if the patient has
93	93	63additional risk factors for breast cancer including, but not limited to, family history, prior
94	94	64personal history of breast cancer, positive genetic testing, heterogeneously or extremely dense
95	95	65breast tissue based on the Breast Imaging Reporting and Data System established by the
96	96	66American College of Radiology, or other indications as determined by the patient’s health care
97	97	67provider, (v) for a diagnostic mammogram, which may include tomosynthesis, diagnostic breast
98	98	68ultrasound evaluation or breast magnetic resonance imaging scan if the patient has a history of
99	99	69breast cancer, (vi) for magnetic resonance imaging in place of, or in addition to, a mammogram
100	100	70when a mammogram is unable to detect cancers due to insufficient breast tissue as ordered by a
101	101	71patient’s physician. Said benefits shall be exempt from any co-payment, co-insurance, deductible
102	102	72or dollar limit provisions in a policy or contract.
103	103	73 SECTION 4: Section 4I of Chapter 176B of the General Laws, as appearing in the 2012
104	104	74Official Edition, is hereby amended, in line 12, by striking the language after the word
105	105	75“examination” and inserting in place thereof the following language:-
106	106	76 : (1) said benefits shall provide: (i) for a baseline mammogram, which may include
107	107	77tomosynthesis, for women between the ages of thirty-five and forty and for a mammogram on an
108	108	78annual basis, which may include tomosynthesis, for women forty years of age or older; (ii) in the
109	109	79case of a woman under forty years of age who has a family history of breast cancer or other 5 of 8
110	110	80breast cancer risk factors, a mammogram examination, which may include tomosynthesis, at
111	111	81such age and intervals as deemed medically necessary by the woman’s health care provider; (iii)
112	112	82ultrasound evaluation, magnetic resonance imaging scan or additional mammography testing,
113	113	83which may include tmosynthesis, of an entire breast or breasts if the screening mammogram,
114	114	84screening ultrasound or MRI shows any abnormality where additional examination is deemed
115	115	85medically necessary by the radiologist or the patient’s health care provider, (iv) screening breast
116	116	86ultrasound or screening breast magnetic resonance imaging examination if the patient has
117	117	87additional risk factors for breast cancer including, but not limited to, family history, prior
118	118	88personal history of breast cancer, positive genetic testing, heterogeneously or extremely dense
119	119	89breast tissue based on the Breast Imaging Reporting and Data System established by the
120	120	90American College of Radiology, or other indications as determined by the patient’s health care
121	121	91provider, (v) for a diagnostic mammogram, which may include tomosynthesis, diagnostic breast
122	122	92ultrasound evaluation or breast magnetic resonance imaging scan if the patient has a history of
123	123	93breast cancer, (vi) for magnetic resonance imaging in place of, or in addition to, a mammogram
124	124	94when a mammogram is unable to detect cancers due to insufficient breast tissue as ordered by a
125	125	95patient’s physician. Said benefits shall be exempt from any co-payment, co-insurance, deductible
126	126	96or dollar limit provisions in a policy or contract.
127	127	97 SECTION 5: Section 47G of Chapter 175 of the General Laws, as appearing in the 2012
128	128	98Official Edition, is hereby amended, in line 21, by striking out the word “women” and inserting
129	129	99in place thereof the word “patients”.
130	130	100 SECTION 6: Section 47G of Chapter 175 of the General Laws, as appearing in the 2012
131	131	101Official Edition, is hereby amended, in line 22, by striking out the word “women” and inserting
132	132	102in place thereof the word “patients”. 6 of 8
133	133	103 SECTION 7: Section 110 of Chapter 175 of the General Laws, as appearing in the 2012
134	134	104Official Edition, is hereby amended, in line 323, by striking out the word “women” and inserting
135	135	105in place thereof the word “patients”.
136	136	106 SECTION 8: Section 110 of Chapter 175 of the General Laws, as appearing in the 2012
137	137	107Official Edition, is hereby amended, in line 324, by striking out the word “women” and inserting
138	138	108in place thereof the word “patients”.
139	139	109 SECTION 9: Section 8J of Chapter 176A of the General Laws, as appearing in the 2012
140	140	110Official Edition, is hereby amended, in line 13, by striking out the word “women” and inserting
141	141	111in place thereof the word “patients”.
142	142	112 SECTION 10: Section 8J of Chapter 176A of the General Laws, as appearing in the 2012
143	143	113Official Edition, is hereby amended, in line 15, by striking out the word “women” and inserting
144	144	114in place thereof the word “patients”.
145	145	115 SECTION 11: Section 4I of Chapter 176B of the General Laws, as appearing in the 2012
146	146	116Official Edition, is hereby amended, in line 13, by striking out the word “women” and inserting
147	147	117in place thereof the word “patients”.
148	148	118 SECTION 12: Section 4I of Chapter 176B of the General Laws, as appearing in the 2012
149	149	119Official Edition, is hereby amended, in line 14, by striking out the word “women” and inserting
150	150	120in place thereof the word “patients”.
151	151	121 SECTION 13. Chapter 32A of the General Laws as amended by Chapter 403 of the Acts
152	152	122of 2012, is hereby amended by inserting after section 17K the following section:- 7 of 8
153	153	123 Section 17L. The commission shall provide to any active or retired employee of the
154	154	124commonwealth who is insured under the group insurance commission, coverage for the cost of a
155	155	125mastectomy and coverage for a minimum of 48 hours in-patient care.
156	156	126 SECTION 14. Chapter 175 of the General Laws as amended by Chapter 403 of the Acts
157	157	127of 2012, is hereby amended by inserting after section 47DD the following section:-
158	158	128 Section 47EE. Any policy of accident or sickness insurance delivered, issued or renewed
159	159	129in the commonwealth pursuant to this chapter shall provide coverage for the cost of a
160	160	130mastectomy and coverage for a minimum of 48 hours in-patient care.
161	161	131 SECTION 15. Chapter 176A as amended by Chapter 403 of the Acts of 2012, is hereby
162	162	132amended by inserting after section 8EE the following section:-
163	163	133 Section 8FF. Any contract between a subscriber and the corporation under an individual
164	164	134or group hospital service plan, which is issued or renewed within or without the commonwealth
165	165	135shall provide for coverage of the cost of a mastectomy and coverage for a minimum of 48 hours
166	166	136in-patient care.
167	167	137 SECTION 16. Chapter 176B of the General Laws in hereby amended by inserting after
168	168	138section 4FF the following section:-
169	169	139 Section 4GG. Any subscription certificate under an individual or group medical service
170	170	140agreement delivered or issued or renewed within the commonwealth shall provide for coverage
171	171	141of the cost of a mastectomy and coverage for a minimum of 48 hours in-patient care.
172	172	142 SECTION 17. Chapter 176G of the General Laws is hereby amended by inserting after
173	173	143section 4X the following section:- 8 of 8
174	174	144 Section 4Y. Any individual or group maintenance contract issued, renewed, or delivered
175	175	145within or without the commonwealth shall provide coverage for the cost of a mastectomy and
176	176	146coverage for a minimum of 48 hours in-patient care.