2023 -- S 1134
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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 --
MAMMOGRAMS AND PAP S MEARS -- COVERAGE MANDATED
Introduced By: Senators Sosnowski, Miller, and Pearson
Date Introduced: June 15, 2023
Referred To: Placed on Senate Calendar
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: 10
(A) Two two (2) screening mammograms per year when recommended by a physician for 11
women who have been treated for breast cancer within the last five (5) years or are at high risk of 12
developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple first 13
degree relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical ductal 14
hyperplasia.; and 15
(B) Any screening deemed medically necessary for proper breast cancer screening in 16
accordance with applicable American College of Radiology guidelines including, but not limited 17
to, magnetic resonance imaging, ultrasound, or molecular breast imaging for any person who has 18
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received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue. 1
(b) This section shall not apply to insurance coverage providing benefits for: (1) hospital 2
confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare 3
supplement; (6) limited benefit health; (7) specified disease indemnity; (8) sickness or bodily injury 4
or death by accident or both; and (9) other limited benefit policies. 5
SECTION 2. Section 27-19-20 of the General Laws in Chapter 27-19 entitled "Nonprofit 6
Hospital Service Corporations" is hereby amended to read as follows: 7
27-19-20. Mammograms and pap smears — Coverage mandated. 8
(a) Subscribers to any nonprofit hospital service plan shall be afforded coverage under the 9
plan for mammograms and pap smears, in accordance with guidelines established by the American 10
Cancer Society. 11
(b) Notwithstanding the provisions of this chapter, subscribers to any nonprofit hospital 12
service plan shall be afforded coverage for: 13
(1) Two two (2) screening mammograms per year when recommended by a physician for 14
women who have been treated for breast cancer within the last five (5) years or who are at high risk 15
of developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple first 16
degree relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical ductal 17
hyperplasia.; and 18
(2) Any screening deemed medically necessary for proper breast cancer screening in 19
accordance with applicable American College of Radiology guidelines including, but not limited 20
to, magnetic resonance imaging, ultrasound, or molecular breast imaging for any person who has 21
received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue. 22
SECTION 3. Section 27-20-17 of the General Laws in Chapter 27-20 entitled "Nonprofit 23
Medical Service Corporations" is hereby amended to read as follows: 24
27-20-17. Mammograms and pap smears — Coverage mandated. 25
(a) Subscribers to any nonprofit medical service plan shall be afforded coverage under the 26
plan for mammograms and pap smears, in accordance with guidelines established by the American 27
Cancer Society. 28
(b) Notwithstanding the provisions of this chapter, subscribers to any nonprofit medical 29
service plan shall be afforded coverage for: 30
(1) Two two (2) paid screening mammograms per year when recommended by a physician 31
for women who have been treated for breast cancer within the last five (5) years or who are at high 32
risk of developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple 33
first degree relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical 34
LC003240 - Page 3 of 4
ductal hyperplasia.; and 1
(2) Any screening deemed medically necessary for proper breast cancer screening in 2
accordance with applicable American College of Radiology guidelines including, but not limited 3
to, magnetic resonance imaging, ultrasound, or molecular breast imaging for any person who has 4
received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue. 5
SECTION 4. Section 27-41-30 of the General Laws in Chapter 27-41 entitled "Health 6
Maintenance Organizations" is hereby amended to read as follows: 7
27-41-30. Mammograms and pap smears — Coverage mandated. 8
(a) Subscribers to any health maintenance organization plan shall be afforded coverage 9
under that plan for mammograms and pap smears, in accordance with guidelines established by the 10
American Cancer Society. 11
(b) Notwithstanding the provisions of this chapter, subscribers to any health maintenance 12
organization plan shall be afforded coverage for: 13
(1) Two two (2) paid screening mammograms per year when recommended by a physician 14
for women who have been treated for breast cancer within the last five (5) years or who are at high 15
risk of developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple 16
first degree relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical 17
ductal hyperplasia.; and 18
(2) Any screening deemed medically necessary for proper breast cancer screening in 19
accordance with applicable American College of Radiology guidelines including, but not limited 20
to, magnetic resonance imaging, ultrasound, or molecular breast imaging for any person who has 21
received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue. 22
SECTION 5. This act shall take effect on January 1, 2024. 23
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES --
MAMMOGRAMS AND PAP S MEARS -- COVERAGE MANDATED
***
This act would mandate insurance coverage for any screenings deemed medically 1
necessary for any person who has received notice of dense breast tissue. 2
This act would take effect on January 1, 2024. 3
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