STATE OF NEW YORK ________________________________________________________________________ 7921--A IN SENATE January 3, 2024 ___________ Introduced by Sen. RHOADS -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, in relation to coverage of certain procedures to detect breast cancer The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subparagraph (A) of paragraph 11 of subsection (l) of 2 section 3221 of the insurance law, as amended by chapter 143 of the laws 3 of 2019, is amended to read as follows: 4 (A) Every insurer delivering a group or blanket policy or issuing a 5 group or blanket policy for delivery in this state that provides cover- 6 age for hospital, surgical or medical care shall provide the following 7 coverage for mammography screening for occult breast cancer: 8 (i) upon the recommendation of a physician, a mammogram, which may be 9 provided by breast tomosynthesis, at any age for covered persons having 10 a prior history of breast cancer or who have a first degree relative 11 with a prior history of breast cancer; 12 (ii) a single baseline mammogram, which may be provided by breast 13 tomosynthesis[, for covered persons aged thirty-five through thirty- 14 nine, inclusive]; and 15 (iii) [an annual mammogram, which may be provided by breast tomosyn- 16 thesis, for covered persons aged forty and older; and 17 (iv)] for large group policies that provide coverage for hospital, 18 surgical or medical care, [an annual mammogram] mammograms for covered 19 persons [aged thirty-five through thirty-nine, inclusive] having a prior 20 history of breast cancer or who have a first degree relative with a 21 prior history of breast cancer, or any sonogram or other diagnostic 22 procedure used to detect breast cancer, upon the recommendation of a 23 physician, subject to the insurer's determination that the mammogram is 24 medically necessary. EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD11825-03-4
S. 7921--A 2 1 § 2. Subparagraph (D) of paragraph 1 of subsection (p) of section 4303 2 of the insurance law, as amended by chapter 143 of the laws of 2019, is 3 amended to read as follows: 4 (D) for large group contracts offered by a medical expense indemnity 5 corporation, a hospital service corporation or a health service corpo- 6 ration that provide coverage for hospital, surgical or medical care, [an 7 annual mammogram] mammograms for covered persons [aged thirty-five 8 through thirty-nine, inclusive] having a prior history of breast cancer 9 or who have a first degree relative with a prior history of breast 10 cancer, or any sonogram or other diagnostic procedure used to detect 11 breast cancer, upon the recommendation of a physician, subject to the 12 corporation's determination that the mammogram is medically necessary; 13 and 14 § 3. This act shall take effect on the thirtieth day after it shall 15 have become a law, and shall apply to policies and contracts issued, 16 renewed, modified, altered or amended on or after such effective date.