STATE OF NEW YORK ________________________________________________________________________ 2465--A 2023-2024 Regular Sessions IN SENATE January 20, 2023 ___________ Introduced by Sens. PERSAUD, CHU, JACKSON, KENNEDY, MYRIE, PALUMBO, SEPULVEDA -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- recommitted to the Commit- tee on Insurance in accordance with Senate Rule 6, sec. 8 -- reported favorably from said committee and committed to the Committee on Finance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law and the social services law, in relation to requiring certain insurance policies and Medicaid to allow patients a one hundred twenty-day window for additional breast exams when the provider deems another breast exam is needed The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subparagraph (D) of paragraph 11 of subsection (i) of 2 section 3216 of the insurance law, as amended by chapter 219 of the laws 3 of 2011, is amended to read as follows: 4 (D) In addition to subparagraph (A), (B) or (C) of this paragraph, 5 every policy that provides coverage for hospital, surgical or medical 6 care, except for a grandfathered health plan under subparagraph (E) of 7 this paragraph, shall provide coverage for the following mammography 8 screening services, and such coverage shall not be subject to annual 9 deductibles or coinsurance: 10 (i) evidence-based items or services for mammography that have in 11 effect a rating of 'A' or 'B' in the current recommendations of the 12 United States preventive services task force; [and] 13 (ii) with respect to women, such additional preventive care and 14 screenings for mammography not described in item (i) of this subpara- 15 graph and as provided for in comprehensive guidelines supported by the 16 health resources and services administration[.]; and 17 (iii) an additional screening including a mammogram, which may be 18 provided by breast tomosynthesis, for covered persons whose mammogram, EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD02639-06-4
S. 2465--A 2 1 which occurred in the previous one hundred and twenty days, showed 2 abnormalities due to dense breast, or when the provider deems another 3 mammogram is needed. 4 § 2. Subparagraph (D) of paragraph 11 of subsection (l) of section 5 3221 of the insurance law, as amended by chapter 219 of the laws of 6 2011, is amended to read as follows: 7 (D) In addition to subparagraph (A), (B) or (C) of this paragraph, 8 every group or blanket policy that provides coverage for hospital, 9 surgical or medical care, except for a grandfathered health plan under 10 subparagraph (E) of this paragraph, shall provide coverage for the 11 following mammography screening services, and such coverage shall not be 12 subject to annual deductibles or coinsurance: 13 (i) evidence-based items or services for mammography that have in 14 effect a rating of 'A' or 'B' in the current recommendations of the 15 United States preventive services task force; [and] 16 (ii) with respect to women, such additional preventive care and 17 screenings for mammography not described in item (i) of this subpara- 18 graph and as provided for in comprehensive guidelines supported by the 19 health resources and services administration[.]; and 20 (iii) an additional screening including a mammogram, which may be 21 provided by breast tomosynthesis, for covered persons whose mammogram, 22 which occurred in the previous one hundred and twenty days, showed 23 abnormalities due to dense breast, or when the provider deems another 24 mammogram is needed. 25 § 3. Paragraph 3 of subsection (p) of section 4303 of the insurance 26 law, as added by chapter 219 of the laws of 2011, is amended to read as 27 follows: 28 (3) In addition to paragraph one or two of this subsection, every 29 contract that provides coverage for hospital, surgical or medical care, 30 except for a grandfathered health plan under paragraph four of this 31 subsection, shall provide coverage for the following mammography screen- 32 ing services, and such coverage shall not be subject to annual deduct- 33 ibles or coinsurance: 34 (A) evidence-based items or services for mammography that have in 35 effect a rating of 'A' or 'B' in the current recommendations of the 36 United States preventive services task force; [and] 37 (B) with respect to women, such additional preventive care and screen- 38 ings for mammography not described in subparagraph (A) of this paragraph 39 and as provided for in comprehensive guidelines supported by the health 40 resources and services administration[.]; and 41 (C) an additional screening including a mammogram, which may be 42 provided by breast tomosynthesis, for covered persons whose mammogram, 43 which occurred in the previous one hundred and twenty days, showed 44 abnormalities due to dense breast, or when the provider deems another 45 mammogram is needed. 46 § 4. Subdivision 2 of section 365-a of the social services law is 47 amended by adding a new paragraph (nn) to read as follows: 48 (nn) a mammogram, which may be provided by breast tomosynthesis, for 49 covered persons whose mammogram, which occurred in the previous one 50 hundred twenty days, showed abnormalities due to dense breast or when 51 the provider deems another mammogram is needed. 52 § 5. This act shall take effect January 1, 2026 and shall apply to 53 all policies and contracts issued, renewed, modified, altered or amended 54 on or after such date.