Rhode Island 2023 Regular Session

Rhode Island Senate Bill S0294 Compare Versions

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

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5	5	2023 -- S 0294
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7	7	LC000089
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9	9	S TATE OF RHODE IS LAND
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2023
12	12	____________
13	13
14	14	A N A C T
15	15	RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
16	16	Introduced By: Senators Sosnowski, Goodwin, Gallo, DiMario, Valverde, Murray, and
17	17	Lauria
18	18	Date Introduced: February 16, 2023
19	19	Referred To: Senate Health & Human Services
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22	22	It is enacted by the General Assembly as follows:
23	23	SECTION 1. Section 27-18-41 of the General Laws in Chapter 27-18 entitled "Accident 1
24	24	and Sickness Insurance Policies" is hereby amended to read as follows: 2
25	25	27-18-41. Mammograms and pap smears -- Coverage mandated. 3
26	26	(a)(1) Every individual or group hospital or medical expense insurance policy or individual 4
27	27	or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this 5
28	28	state shall provide coverage for mammograms and pap smears, in accordance with guidelines 6
29	29	established by the American Cancer Society. 7
30	30	(2) Notwithstanding the provisions of this chapter, every individual or group hospital or 8
31	31	medical insurance policy or individual or group hospital or medical services plan contract 9
32	32	delivered, issued for delivery, or renewed in this state shall pay for two (2) screening mammograms 10
33	33	per year when recommended by a physician for women who have been treated for breast cancer 11
34	34	within the last five (5) years or are at high risk of developing breast cancer due to genetic 12
35	35	predisposition (BRCA gene mutation or multiple first degree relatives) or high risk lesion on prior 13
36	36	biopsy (lobular carcinoma in situ) or atypical ductal hyperplasia and for any person who has 14
37	37	received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue, coverage shall be 15
38	38	provided for the costs of breast ultrasound screenings, breast MRI exams and/or digital breast 16
39	39	tomosynthesis (DBT) screenings. 17
40	40	(b) This section shall not apply to insurance coverage providing benefits for: (1) hospital 18
41	41	confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare 19
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45	45	supplement; (6) limited benefit health; (7) specified disease indemnity; (8) sickness or bodily injury 1
46	46	or death by accident or both; and (9) other limited benefit policies. 2
47	47	SECTION 2. Section 27-19-20 of the General Laws in Chapter 27-19 entitled "Nonprofit 3
48	48	Hospital Service Corporations" is hereby amended to read as follows: 4
49	49	27-19-20. Mammograms and pap smears -- Coverage mandated. 5
50	50	(a) Subscribers to any nonprofit hospital service plan shall be afforded coverage under the 6
51	51	plan for mammograms and pap smears, in accordance with guidelines established by the American 7
52	52	Cancer Society. 8
53	53	(b) Notwithstanding the provisions of this chapter, subscribers to any nonprofit hospital 9
54	54	service plan shall be afforded coverage for two (2) screening mammograms per year when 10
55	55	recommended by a physician for women who have been treated for breast cancer within the last 11
56	56	five (5) years or who are at high risk of developing breast cancer due to genetic predisposition 12
57	57	(BRCA gene mutation or multiple first degree relatives) or high risk lesion on prior biopsy (lobular 13
58	58	carcinoma in situ) or atypical ductal hyperplasia and for any person who has received notice 14
59	59	pursuant to § 23-12.9-2 of the existence of dense breast tissue, coverage shall be provided for the 15
60	60	costs of breast ultrasound screenings, breast MRI exams and/or digital breast tomosynthesis (DBT) 16
61	61	screenings. 17
62	62	SECTION 3. Section 27-20-17 of the General Laws in Chapter 27-20 entitled "Nonprofit 18
63	63	Medical Service Corporations" is hereby amended to read as follows: 19
64	64	27-20-17. Mammograms and pap smears -- Coverage mandated. 20
65	65	(a) Subscribers to any nonprofit medical service plan shall be afforded coverage under the 21
66	66	plan for mammograms and pap smears, in accordance with guidelines established by the American 22
67	67	Cancer Society. 23
68	68	(b) Notwithstanding the provisions of this chapter, subscribers to any nonprofit medical 24
69	69	service plan shall be afforded coverage for two (2) paid screening mammograms per year when 25
70	70	recommended by a physician for women who have been treated for breast cancer within the last 26
71	71	five (5) years or who are at high risk of developing breast cancer due to genetic predisposition 27
72	72	(BRCA gene mutation or multiple first degree relatives) or high risk lesion on prior biopsy (lobular 28
73	73	carcinoma in situ) or atypical ductal hyperplasia and for any person who has received notice 29
74	74	pursuant to § 23-12.9-2 of the existence of dense breast tissue, coverage shall be provided for the 30
75	75	costs of breast ultrasound screenings, breast MRI exams and/or digital breast tomosynthesis (DBT) 31
76	76	screenings. 32
77	77	SECTION 4. Section 27-41-30 of the General Laws in Chapter 27-41 entitled "Health 33
78	78	Maintenance Organizations" is hereby amended to read as follows: 34
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82	82	27-41-30. Mammograms and pap smears -- Coverage mandated. 1
83	83	(a) Subscribers to any health maintenance organization plan shall be afforded coverage 2
84	84	under that plan for mammograms and pap smears, in accordance with guidelines established by the 3
85	85	American Cancer Society. 4
86	86	(b) Notwithstanding the provisions of this chapter, subscribers to any health maintenance 5
87	87	organization plan shall be afforded coverage for two (2) paid screening mammograms per year 6
88	88	when recommended by a physician for women who have been treated for breast cancer within the 7
89	89	last five (5) years or who are at high risk of developing breast cancer due to genetic predisposition 8
90	90	(BRCA gene mutation or multiple first degree relatives) or high risk lesion on prior biopsy (lobular 9
91	91	carcinoma in situ) or atypical ductal hyperplasia and for any person who has received notice 10
92	92	pursuant to § 23-12.9-2 of the existence of dense breast tissue, coverage shall be provided for the 11
93	93	costs of breast ultrasound screenings, breast MRI exams and/or digital breast tomosynthesis (DBT) 12
94	94	screenings. 13
95	95	SECTION 5. This act shall take effect upon passage. 14
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97	97	LC000089
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102	102	EXPLANATION
103	103	BY THE LEGISLATIVE COUNCIL
104	104	OF
105	105	A N A C T
106	106	RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES
107	107	***
108	108	This act would require insurance carriers, nonprofit hospital service plans, nonprofit 1
109	109	medical service corporations and health maintenance organizations to cover the costs of breast 2
110	110	ultrasounds and/or MRI breast exams for any person receiving notice of dense breast tissue 3
111	111	pursuant to § 23-12.9-2 ("The Dense Breast Notification and Education Act"). 4
112	112	This act would take effect upon passage. 5
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