NY State Senate Bill 2023-S2917A

Senate Bill S2917A

2023-2024 Legislative Session

Allows a notice of dense breast tissue to be determination of medical necessity for coverage of a breast ultrasound

download bill text pdf

Current Bill Status - In Senate Committee Finance Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Actions

View Actions

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 06, 2024	reported and committed to finance
Mar 19, 2024	print number 2917a
Mar 19, 2024	amend and recommit to insurance
Feb 13, 2024	reported and committed to insurance
Jan 03, 2024	referred to health
Mar 15, 2023	reported and committed to insurance
Jan 25, 2023	referred to health

Votes

- May 6, 2024 - Insurance Committee Vote
  S2917A
  
  9
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  1
  
  Excused
  
  0
  
  Abstained
  - - Insurance Committee Vote: May 6, 2024
      
      aye (9)
      
      Addabbo Jr.
      
      Ashby
      
      Breslin
      
      Cooney
      
      Harckham
      
      Helming
      
      Martinez
      
      Sanders Jr.
      
      Scarcella-Spanton
      
      excused (1)
      
      O'Mara
  Feb 13, 2024 - Health Committee Vote
  S2917A
  
  15
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: Feb 13, 2024
      
      aye (15)
      
      Ashby
      
      Brouk
      
      Felder
      
      Gallivan
      
      Hoylman-Sigal
      
      Mannion
      
      Martins
      
      May
      
      Myrie
      
      Rhoads
      
      Rivera
      
      Salazar
      
      Stec
      
      Thomas
      
      Webb
  Mar 14, 2023 - Health Committee Vote
  S2917A
  
  15
  
  Aye
  
  0
  
  Nay
  
  0
  
  Aye with Reservations
  
  0
  
  Absent
  
  0
  
  Excused
  
  0
  
  Abstained
  - - Health Committee Vote: Mar 14, 2023
      
      aye (15)
      
      Ashby
      
      Brouk
      
      Felder
      
      Gallivan
      
      Hoylman-Sigal
      
      Mannion
      
      Martins
      
      May
      
      Myrie
      
      Rhoads
      
      Rivera
      
      Salazar
      
      Stec
      
      Thomas
      
      Webb

Bill Amendments

Original

A (Active)

co-Sponsors

View additional co-sponsors

2023-S2917 - Details

See Assembly Version of this Bill:: A2516
Current Committee:: Senate Finance
Law Section:: Public Health Law
Laws Affected:: Amd §2404-c, Pub Health L
Versions Introduced in 2021-2022 Legislative Session:: S7647, A8814

2023-S2917 - Summary

Allows a notice of dense breast tissue to be considered a determination of medical necessity for purposes of coverage of breast ultrasounds as recommended by a provider of mammography services.

2023-S2917 - Sponsor Memo

                                 
BILL NUMBER: S2917

SPONSOR: CLEARE
 
TITLE OF BILL:

An act to amend the public health law, in relation to allowing a notice
of dense breast tissue to be considered a determination of medical
necessity for coverage of a breast ultrasound

 
PURPOSE OR GENERAL IDEA OF BILL:

To provide that where a patient has received notice that their mammogram
shows that the patient has dense breast tissue, such notice shall be
considered a determination of medical necessity for purposes of coverage
of breast ultrasounds.

 
SUMMARY OF PROVISIONS:

Section one adds a new subdivision 2 to section 2404c of the public
health law to provide that where a provider of mammography services has
provided notice to a patient that their mammogram detected dense breast
tissue, the notice shall be considered a determination of medical neces-

sity for purposes of coverage of breast ultrasounds as recommended by
the provider.

Section two provide the effective date.

 
JUSTIFICATION:

Current New York State Law requires insurance companies to cover the
cost of mammograms. In addition, providers must give notice to a patient
when a mammogram shows that the patient has dense breast tissue. Having
dense breasts can make it more difficult to detect certain forms of
breast cancer, particularly some of the more aggressive forms, through a
mammogram alone. It also puts women at about a twofold risk for develop-
ing cancer as compared to those who do not have dense breasts. Conduct-
ing an ultrasound along with a regular mammogram is essential to improv-
ing cancer detection for women with dense breasts.

Ultrasounds for dense breasts are only covered by insurers if they are
found to be a medical necessity. This legislation amends the Public
Health Law to provide that the notice given by a provider to a patient
that the patient has dense breasts shall be considered a determination
of medical necessity for purposes of coverage of ultrasounds.

Early detection is key to preventing women from developing aggressive
forms of breast cancer and improving survival rates. This legislation
will prevent the unnecessary delay and stress imposed when an insurance
company denies coverage for this critical service.

 
PRIOR LEGISLATIVE HISTORY:

New bill

 
FISCAL IMPLICATIONS:

None

 
EFFECTIVE DATE:
This act shall take effect immediately.

2023-S2917 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2917
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 25, 2023
                                ___________
 
 Introduced  by  Sen.  CLEARE -- read twice and ordered printed, and when
   printed to be committed to the Committee on Health
 
 AN ACT to amend the public health law, in relation to allowing a  notice
   of  dense  breast  tissue  to be considered a determination of medical
   necessity for coverage of a breast ultrasound

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1. Section 2404-c of the public health law, as added by chap-
 ter 265 of the laws of 2012, is amended to read as follows:
   § 2404-c. Breast cancer; duty of providers of mammography services  to
 notify and inform. 1. Every provider of mammography services shall, if a
 patient's  mammogram demonstrates dense breast tissue, provide notifica-
 tion to such patient that shall include, but  not  be  limited  to,  the
 following  information,  in  any summary of the mammography report sent,
 pursuant to the  federal  mammography  quality  standards  act,  to  the
 patient:
   Your  mammogram  shows  that your breast tissue is dense. Dense breast
 tissue is very common and is not abnormal. However, dense breast  tissue
 can make it harder to find cancer on a mammogram and may also be associ-
 ated with an increased risk of breast cancer.
   This information about the result of your mammogram is given to you to
 raise  your awareness. Use this information to talk to your doctor about
 your own risks for breast cancer. At that time, ask your doctor if  more
 screening  tests  might  be useful, based on your risk. A report of your
 results was sent to your physician.
   For the purposes of this section dense breast tissue shall mean heter-
 ogeneously dense or extremely dense  tissue  as  defined  in  nationally
 recognized guidelines or systems for breast imaging reporting of mammog-
 raphy  screening,  including,  but  not  limited  to, the breast imaging
 reporting and data system of the American College of Radiology, and  any
 equivalent new terms, as such guidelines or systems are updated.

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05349-01-3

 S. 2917                             2
 
   2.  WHERE  A PROVIDER OF MAMMOGRAPHY SERVICES HAS PROVIDED NOTICE TO A
 PATIENT UNDER SUBDIVISION ONE OF  THIS  SECTION,  THE  NOTICE  SHALL  BE
 CONSIDERED A DETERMINATION OF MEDICAL NECESSITY FOR PURPOSES OF COVERAGE
 OF A BREAST ULTRASOUND AS RECOMMENDED BY THE PROVIDER.
   § 2.  This act shall take effect immediately.

co-Sponsors

View additional co-sponsors

2023-S2917A (ACTIVE) - Details

See Assembly Version of this Bill:: A2516
Current Committee:: Senate Finance
Law Section:: Public Health Law
Laws Affected:: Amd §2404-c, Pub Health L
Versions Introduced in 2021-2022 Legislative Session:: S7647, A8814

2023-S2917A (ACTIVE) - Summary

Allows a notice of dense breast tissue to be considered a determination of medical necessity for purposes of coverage of breast ultrasounds as recommended by a provider of mammography services.

2023-S2917A (ACTIVE) - Sponsor Memo

                                 
BILL NUMBER: S2917A

SPONSOR: CLEARE
 
PURPOSE OR GENERAL IDEA OF BILL:

To provide that where a patient has received notice that their mammogram
shows that the patient has dense breast tissue, such notice shall be
considered a determination of medical necessity for purposes of coverage
of breast ultrasounds.

 
SUMMARY OF PROVISIONS:

Section one adds a new subdivision 2 to section 2404c of the public
health law to provide that where a provider of mammography services has
provided notice to a patient that their mammogram detected dense breast
tissue, the notice shall be considered a determination of medical neces-
sity for purposes of coverage of breast ultrasounds.

Section two provide the effective date.

 
JUSTIFICATION:

Current New York State Law requires insurance companies to cover the
cost of mammograms. In addition, providers must give notice to a patient
when a mammogram shows that the patient has dense breast tissue. Having
dense breasts can make it more difficult to detect certain forms of
breast cancer, particularly some of the more aggressive forms, through a
mammogram alone. It also puts women at about a twofold risk for develop-
ing cancer as compared to those who do not have dense breasts. Conduct-
ing an ultrasound along with a regular mammogram is essential to improv-
ing cancer detection for women with dense breasts.

Ultrasounds for dense breasts are only covered by insurers if they are
found to be a medical necessity. This legislation amends the Public
Health Law to provide that the notice given by a provider to a patient
that the patient has dense breasts shall be considered a determination
of medical necessity for purposes of coverage of ultrasounds.

Early detection is key to preventing women from developing aggressive
forms of breast cancer and improving survival rates. This legislation
will prevent the unnecessary delay and stress imposed when an insurance
company denies coverage for this critical service. PRIOR LEGISLATIVE

 
PRIOR LEGISLATIVE HISTORY:

A.8814 of 2021 and 2022, referred to insurance / S.7647 reported and
committed to finance.

 
FISCAL IMPLICATIONS:

None.

 
EFFECTIVE DATE:
This act shall take effect immediately.

2023-S2917A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  2917--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 25, 2023
                                ___________
 
 Introduced  by  Sens.  CLEARE,  ASHBY, COMRIE, FERNANDEZ, HOYLMAN-SIGAL,
   PALUMBO -- read twice and ordered printed,  and  when  printed  to  be
   committed  to  the Committee on Health -- recommitted to the Committee
   on Health in accordance with Senate Rule 6, sec. 8 -- reported favora-
   bly from said committee and committed to the Committee on Insurance --
   committee discharged, bill amended, ordered reprinted as  amended  and
   recommitted to said committee
 
 AN  ACT to amend the public health law, in relation to allowing a notice
   of dense breast tissue to be considered  a  determination  of  medical
   necessity for coverage of a breast ultrasound
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 2404-c of the public health law, as added by  chap-
 ter 265 of the laws of 2012, is amended to read as follows:
   §  2404-c. Breast cancer; duty of providers of mammography services to
 notify and inform. 1. Every provider of mammography services shall, if a
 patient's mammogram demonstrates dense breast tissue, provide  notifica-
 tion  to  such  patient  that  shall include, but not be limited to, the
 following information, in any summary of the  mammography  report  sent,
 pursuant  to  the  federal  mammography  quality  standards  act, to the
 patient:
   Your mammogram shows that your breast tissue is  dense.  Dense  breast
 tissue  is very common and is not abnormal. However, dense breast tissue
 can make it harder to find cancer on a mammogram and may also be associ-
 ated with an increased risk of breast cancer.
   This information about the result of your mammogram is given to you to
 raise your awareness. Use this information to talk to your doctor  about
 your  own risks for breast cancer. At that time, ask your doctor if more
 screening tests might be useful, based on your risk. A  report  of  your
 results was sent to your physician.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05349-03-4
 S. 2917--A                          2

 
   For the purposes of this section dense breast tissue shall mean heter-
 ogeneously  dense  or  extremely  dense  tissue as defined in nationally
 recognized guidelines or systems for breast imaging reporting of mammog-
 raphy screening, including, but  not  limited  to,  the  breast  imaging
 reporting  and data system of the American College of Radiology, and any
 equivalent new terms, as such guidelines or systems are updated.
   2. WHERE A PROVIDER OF MAMMOGRAPHY SERVICES HAS PROVIDED NOTICE  TO  A
 PATIENT  UNDER  SUBDIVISION  ONE  OF  THIS  SECTION, THE NOTICE SHALL BE
 CONSIDERED A DETERMINATION OF MEDICAL NECESSITY FOR PURPOSES OF COVERAGE
 OF A BREAST ULTRASOUND.
   § 2.  This act shall take effect immediately.

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Senate Bill S2917A

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Sponsored By

Current Bill Status - In Senate Committee Finance Committee

Bill Amendments

co-Sponsors

2023-S2917 - Details

2023-S2917 - Summary

2023-S2917 - Sponsor Memo

2023-S2917 - Bill Text download pdf

co-Sponsors

2023-S2917A (ACTIVE) - Details

2023-S2917A (ACTIVE) - Summary

2023-S2917A (ACTIVE) - Sponsor Memo

2023-S2917A (ACTIVE) - Bill Text download pdf

Comments