Bill Text: NY S03852 | 2019-2020 | General Assembly | Amended


Bill Title: Enacts "Shannon's law"; relates to requiring insurance companies to cover annual mammograms for breast cancer screening for covered persons aged thirty-five and older.

Spectrum: Strong Partisan Bill (Democrat 12-1)

Status: (Engrossed) 2019-06-18 - returned to senate [S03852 Detail]

Download: New_York-2019-S03852-Amended.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                         3852--A
            Cal. No. 465

                               2019-2020 Regular Sessions

                    IN SENATE

                                    February 20, 2019
                                       ___________

        Introduced  by Sens. MARTINEZ, BOYLE, BROOKS, CARLUCCI, KAMINSKY, MYRIE,
          RAMOS, SALAZAR, THOMAS -- read twice and  ordered  printed,  and  when
          printed  to  be  committed  to  the Committee on Insurance -- reported
          favorably from said committee, ordered to  first  and  second  report,
          ordered  to  a third reading, amended and ordered reprinted, retaining
          its place in the order of third reading

        AN ACT to amend the insurance law, in relation  to  enacting  "Shannon's
          Law"

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. Short title. This act shall be known and may  be  cited  as
     2  "Shannon's Law".
     3    §  2.  Subparagraph  (A)  of paragraph 11 of subsection (l) of section
     4  3221 of the insurance law, as amended by chapter  414  of  the  laws  of
     5  2017, is amended to read as follows:
     6    (A)  Every  insurer  delivering a group or blanket policy or issuing a
     7  group or blanket policy for delivery in this state that provides  cover-
     8  age  for  hospital, surgical or medical care shall provide the following
     9  coverage for mammography screening for occult breast cancer:
    10    (i) upon the recommendation of a physician, a mammogram, which may  be
    11  provided  by breast tomosynthesis, at any age for covered persons having
    12  a prior history of breast cancer or who have  a  first  degree  relative
    13  with a prior history of breast cancer;
    14    (ii)  a  single  baseline  mammogram,  which may be provided by breast
    15  tomosynthesis, for covered persons aged thirty-five through thirty-nine,
    16  inclusive; [and]
    17    (iii) an annual mammogram, which may be provided by breast tomosynthe-
    18  sis, for covered persons aged forty and older[.]; and
    19    (iv) for large group policies  that  provide  coverage  for  hospital,
    20  surgical  or  medical care, an annual mammogram for covered persons aged
    21  thirty-five through thirty-nine, inclusive, upon the recommendation of a

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD09044-02-9

        S. 3852--A                          2

     1  physician, subject to the insurer's determination that the mammogram  is
     2  medically necessary.
     3    §  3.  Subparagraphs (B), (C) and (D) of paragraph 1 of subsection (p)
     4  of section 4303 of the insurance  law,  subparagraphs  (B)  and  (C)  as
     5  amended  by chapter 414 of the laws of 2017, subparagraph (D) as amended
     6  by chapter 74 of the laws of 2016, are amended to read as follows:
     7    (B) a single baseline mammogram, which may be provided by breast tomo-
     8  synthesis, for covered persons  aged  thirty-five  through  thirty-nine,
     9  inclusive; [and]
    10    (C) an annual mammogram, which may be provided by breast tomosythesis,
    11  for covered persons aged forty and older[.];
    12    (D)  for  large group contracts offered by a medical expense indemnity
    13  corporation, a hospital service corporation or a health  service  corpo-
    14  ration  that provide coverage for hospital, surgical or medical care, an
    15  annual mammogram for covered persons aged  thirty-five  through  thirty-
    16  nine,  inclusive, upon the recommendation of a physician, subject to the
    17  corporation's determination that the mammogram is  medically  necessary;
    18  and
    19    (E)  The  coverage required in this paragraph or paragraph two of this
    20  subsection shall not be subject to annual deductibles or coinsurance.
    21    § 4. This act shall take effect on the thirtieth day  after  it  shall
    22  have  become  a  law,  and shall apply to policies and contracts issued,
    23  renewed, modified, altered or amended on or after such effective date.
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