S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4150
 
                        2017-2018 Regular Sessions
 
                             I N  S E N A T E
 
                             February 3, 2017
                                ___________
 
 Introduced  by  Sen.  GRIFFO -- read twice and ordered printed, and when
   printed to be committed to the Committee on Insurance
 
 AN ACT to amend the insurance  law,  in  relation  to  health  insurance
   coverage for mammography by breast tomosynthesis
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subparagraphs (A) and (C) of paragraph (11)  of  subsection
 (i)  of  section 3216 of the insurance law, as amended by chapter 219 of
 the laws of 2011, are amended to read as follows:
   (A) Every policy that provides  coverage  for  hospital,  surgical  or
 medical  care  shall  provide  the  following  coverage  for mammography
 screening for occult breast cancer:
   (i) upon the recommendation of a physician, a mammogram, WHICH MAY  BE
 PROVIDED  BY BREAST TOMOSYNTHESIS, at any age for covered persons having
 a prior history of breast cancer or who have  a  first  degree  relative
 with a prior history of breast cancer;
   (ii)  a  single  baseline  mammogram,  WHICH MAY BE PROVIDED BY BREAST
 TOMOSYNTHESIS, for covered persons aged thirty-five through thirty-nine,
 inclusive; and
   (iii) an annual mammogram, WHICH MAY BE PROVIDED BY BREAST TOMOSYNTHE-
 SIS, for covered persons aged forty and older.
   (C) For purposes of subparagraphs  (A)  and  (B)  of  this  paragraph,
 mammography  screening  means  an  X-ray examination of the breast using
 dedicated equipment, including X-ray tube, filter,  compression  device,
 screens,  films  and cassettes, with an average glandular radiation dose
 less than 0.5 rem per view per breast; PROVIDED, HOWEVER, THAT MAMMOGRA-
 PHY SCREENING SHALL ALSO INCLUDE BREAST TOMOSYNTHESIS.
   § 2. Subparagraphs (A) and (C) of paragraph (11) of subsection (l)  of
 section 3221 of the insurance law, as amended by chapter 219 of the laws
 of 2011, are amended to read as follows:
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD07634-01-7
              

 S. 4150                             2
 
   (A)  Every  insurer  delivering a group or blanket policy or issuing a
 group or blanket policy for delivery in this state that provides  cover-
 age  for  hospital, surgical or medical care shall provide the following
 coverage for mammography screening for occult breast cancer:
   (i)  upon the recommendation of a physician, a mammogram, WHICH MAY BE
 PROVIDED BY BREAST TOMOSYNTHESIS, at any age for covered persons  having
 a  prior  history  of  breast cancer or who have a first degree relative
 with a prior history of breast cancer;
   (ii) a single baseline mammogram, WHICH  MAY  BE  PROVIDED  BY  BREAST
 TOMOSYNTHESIS, for covered persons aged thirty-five through thirty-nine,
 inclusive; and
   (iii) an annual mammogram, WHICH MAY BE PROVIDED BY BREAST TOMOSYNTHE-
 SIS, for covered persons aged forty and older.
   (C)  For  purposes  of  subparagraphs  (A)  and (B) of this paragraph,
 mammography screening means an X-ray examination  of  the  breast  using
 dedicated  equipment,  including X-ray tube, filter, compression device,
 screens, films and cassettes, with an average glandular  radiation  dose
 less than 0.5 rem per view per breast; PROVIDED, HOWEVER, THAT MAMMOGRA-
 PHY SCREENING SHALL ALSO INCLUDE BREAST TOMOSYNTHESIS.
   § 3. Subparagraphs (A), (B) and (C) of paragraph (1) of subsection (p)
 of  section  4303 of the insurance law, as amended by chapter 219 of the
 laws of 2011, are amended to read as follows:
   (A) upon the recommendation of a physician, a mammogram, WHICH MAY  BE
 PROVIDED  BY BREAST TOMOSYNTHESIS, at any age for covered persons having
 a prior history of breast cancer or who have  a  first  degree  relative
 with a prior history of breast cancer;
   (B) a single baseline mammogram, WHICH MAY BE PROVIDED BY BREAST TOMO-
 SYNTHESIS,  for  covered  persons  aged thirty-five through thirty-nine,
 inclusive; and
   (C) an annual mammogram, WHICH MAY BE PROVIDED BY BREAST TOMOSYTHESIS,
 for covered persons aged forty and older.
   § 4. Paragraph (2) of subsection (p) of section 4303 of the  insurance
 law,  as  amended by chapter 219 of the laws of 2011, is amended to read
 as follows:
   (2) For purposes of paragraph  one  of  this  subsection,  mammography
 screening  means  an  X-ray  examination  of  the breast using dedicated
 equipment, including X-ray tube, filter,  compression  device,  screens,
 films  and cassettes, with an average glandular radiation dose less than
 0.5 rem per view per breast; PROVIDED, HOWEVER, THAT MAMMOGRAPHY SCREEN-
 ING SHALL ALSO INCLUDE BREAST TOMOSYTHESIS.
   § 5. This act shall take effect on the sixtieth  day  after  it  shall
 have  become a law and shall apply to all policies and contracts issued,
 renewed, modified, altered or amended on or after such date.