BILL NUMBER: S7785

SPONSOR: MANNION
 
TITLE OF BILL:

An act to amend the insurance law, in relation to including second
degree relatives in certain criteria for breast cancer screenings to be
covered under insurance plans

 
PURPOSE OR GENERAL IDEA OF BILL:

The purpose of this bill is to expand eligibility for breast cancer
screening to individuals with a second degree relative with a prior
history of breast cancer.

 
SUMMARY OF PROVISIONS:

Section 1 of this bill would require that every person insured under an
individual policy of accident and health insurance delivered or issued
for delivery in this state shall be eligible, upon the recommendation of
a physician and who has a second degree relative with a prior history of
breast cancer, for a mammogram at any age.
              

Section 2 of this bill would require that every person insured under a
group or blanket policy of accident and health insurance delivered or
issued for delivery in this state shall be eligible, upon the recommen-
dation of a physician and who has a second degree relative with a prior
history of breast cancer, for a mammogram at any age.

Section 3 of this bill would require that a medical expense indemnity
corporation, a hospital service corporation or a health service corpo-
ration that provides coverage for hospital, surgical or medical care
shall provide coverage for mammography screening for occult breast
cancer at any age for covered persons upon the recommendation of a
physician and who has a second degree relative with a prior history of
breast cancer

Section 4 of this bill provides that the effective date 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.

 
JUSTIFICATION:

Current law, enacted in 1988 and 1989, stipulates that insurance poli-
cies covering hospital, surgical, and medical care must cover mammogra-
phy examinations to detect breast cancer in policyholders over a certain
age, under certain medical conditions, and with a family history of
breast cancer. Mammography screening is recognized as the most effective
means of detecting breast cancer in its early stages, when prospects for
treatment and recovery are greatest. Chapter 692 of the Laws of 1988 and
Chapter 417 of the Laws of 1989 were important first steps in ensuring
the regular, healthy screening of residents and requiring policy cover-
age of critical preventative care. However, medical professionals have
continued to call for increased regular screening for policyholders
under age fifty and for those with greater risks, such as a family
history of breast cancer.


Furthermore, limiting mammography options to the first degree relative
prevents access to some policyholders; for example, if a parent of such
policyholder dies prior to receiving a breast cancer screening in a
family with a known history of breast cancer. In this situation, if such
policyholder had a second degree relative with breast cancer, they may
not be able to utilize care services simply by the happenstance of an
untimely death. Greater access to this essential early detection test
would provide policyholders with better health outcomes. This bill would
expand eligibility for breast cancer screening to individuals with a
second degree relative with a prior history of breast cancer.

 
LEGISLATIVE HISTORY:

This is a new bill.

 
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:

None to the State.

 
EFFECTIVE DATE:
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.