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