NY State Assembly Bill 2025-A6561A

Assembly Bill A6561A

2025-2026 Legislative Session

Includes image-guided biopsies under certain insurance coverage for breast cancer screening

download bill text pdf

Current Bill Status - In Assembly 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

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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Mar 12, 2025	print number 6561a
Mar 12, 2025	amend (t) and recommit to insurance
Mar 06, 2025	referred to insurance

Bill Amendments

Original

A (Active)

2025-A6561 - Details

See Senate Version of this Bill:: S6551
Current Committee:: Assembly Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L

2025-A6561 - Summary

Includes image-guided biopsies under mandatory insurance coverage for breast cancer screening.

2025-A6561 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6561
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 6, 2025
                                ___________
 
 Introduced by M. of A. WEPRIN -- read once and referred to the Committee
   on Insurance
 
 AN ACT to amend the insurance law, in relation to including image-guided
   biopsies  under certain insurance coverage for breast cancer screening
   and providing for mandatory health insurance coverage for lung  cancer
   screening

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Item (iv) of subparagraph (A) of paragraph 11 of subsection
 (i) of section 3216 of the insurance law, as amended by chapter  424  of
 the laws of 2024, is amended to read as follows:
   (iv)  upon the recommendation of a physician, screening and diagnostic
 imaging, including diagnostic  mammograms,  breast  ultrasounds,  IMAGE-
 GUIDED  BREAST  BIOPSIES,  or magnetic resonance imaging, recommended by
 nationally recognized clinical practice guidelines for the detection  of
 breast  cancer.  For  the  purposes of this item, "nationally recognized
 clinical practice guidelines"  means  evidence-based  clinical  practice
 guidelines informed by a systematic review of evidence and an assessment
 of the benefits, and risks of alternative care options intended to opti-
 mize  patient  care  developed  by  independent organizations or medical
 professional societies utilizing a transparent methodology and reporting
 structure and with a conflict of interest policy.
   § 2. Item (v) of subparagraph (A) of paragraph 11 of subsection (l) of
 section 3221 of the insurance law, as amended by chapter 424 of the laws
 of 2024, is amended to read as follows:
   (v) upon the recommendation of a physician, screening  and  diagnostic
 imaging,  including  diagnostic  mammograms,  breast ultrasounds, IMAGE-
 GUIDED BREAST BIOPSIES, or magnetic resonance  imaging,  recommended  by
 nationally  recognized clinical practice guidelines for the detection of
 breast cancer. For the purposes of  this  item,  "nationally  recognized
 clinical  practice  guidelines"  means  evidence-based clinical practice
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD10190-02-5

 A. 6561                             2
 
 guidelines informed by a systematic review of evidence and an assessment
 of the benefits, and risks of alternative care options intended to opti-
 mize patient care developed  by  independent  organizations  or  medical
 professional societies utilizing a transparent methodology and reporting
 structure and with a conflict of interest policy.
   § 3. Subparagraph (E) of paragraph 1 of subsection (p) of section 4303
 of  the insurance law, as amended by chapter 424 of the laws of 2024, is
 amended to read as follows:
   (E) upon the recommendation of a physician, screening  and  diagnostic
 imaging,  including  diagnostic  mammograms,  breast ultrasounds, IMAGE-
 GUIDED BREAST BIOPSIES, or magnetic resonance  imaging,  recommended  by
 nationally  recognized clinical practice guidelines for the detection of
 breast cancer. For the purposes of this subparagraph, "nationally recog-
 nized clinical practice guidelines" means evidence-based clinical  prac-
 tice  guidelines  informed  by  a  systematic  review of evidence and an
 assessment of the  benefits,  and  risks  of  alternative  care  options
 intended to optimize patient care developed by independent organizations
 or  medical  professional  societies utilizing a transparent methodology
 and reporting structure and with a conflict of interest policy; and
   § 4. Subsection (i) of section 3216 of the insurance law is amended by
 adding a new paragraph 41 to read as follows:
   (41) (A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR  SIMI-
 LAR  COMPREHENSIVE-TYPE  COVERAGE SHALL PROVIDE COVERAGE FOR LUNG CANCER
 SCREENING OR FOLLOW-UP DIAGNOSTIC IMAGING TO ASSIST IN THE DIAGNOSIS  OF
 LUNG CANCER WHEN RECOMMENDED BY A HEALTH CARE PROVIDER ACTING WITHIN THE
 PROVIDER'S  SCOPE  OF  PRACTICE PURSUANT TO TITLE EIGHT OF THE EDUCATION
 LAW.
   (B) NOTWITHSTANDING ANY  OTHER  PROVISION  OF  LAW,  ANY  POLICY  THAT
 PROVIDES  COVERAGE  REQUIRED BY THIS PARAGRAPH SHALL NOT IMPOSE A COPAY-
 MENT, COINSURANCE, OR DEDUCTIBLE REQUIREMENT FOR LUNG  CANCER  SCREENING
 OR  FOLLOW-UP  DIAGNOSTIC  IMAGING  TO  ASSIST  IN THE DIAGNOSIS OF LUNG
 CANCER AND SHALL NOT REQUIRE PRIOR AUTHORIZATION FOR SUCH COVERAGE.
   § 5. Subsection (l) of section 3221 of the insurance law is amended by
 adding a new paragraph 23 to read as follows:
   (23) (A) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR  SIMI-
 LAR  COMPREHENSIVE-TYPE  COVERAGE SHALL PROVIDE COVERAGE FOR LUNG CANCER
 SCREENING OR FOLLOW-UP DIAGNOSTIC IMAGING TO ASSIST IN THE DIAGNOSIS  OF
 LUNG CANCER WHEN RECOMMENDED BY A HEALTH CARE PROVIDER ACTING WITHIN THE
 PROVIDER'S  SCOPE  OF  PRACTICE PURSUANT TO TITLE EIGHT OF THE EDUCATION
 LAW.
   (B) NOTWITHSTANDING ANY  OTHER  PROVISION  OF  LAW,  ANY  POLICY  THAT
 PROVIDES  COVERAGE  REQUIRED BY THIS PARAGRAPH SHALL NOT IMPOSE A COPAY-
 MENT, COINSURANCE, OR DEDUCTIBLE REQUIREMENT FOR LUNG  CANCER  SCREENING
 OR  FOLLOW-UP  DIAGNOSTIC  IMAGING  TO  ASSIST  IN THE DIAGNOSIS OF LUNG
 CANCER AND SHALL NOT REQUIRE PRIOR AUTHORIZATION FOR SUCH COVERAGE.
   § 6. Section 4303 of the insurance law is  amended  by  adding  a  new
 subsection (ww) to read as follows:
   (WW)  (1) EVERY POLICY WHICH PROVIDES MEDICAL, MAJOR MEDICAL, OR SIMI-
 LAR COMPREHENSIVE-TYPE COVERAGE SHALL PROVIDE COVERAGE FOR  LUNG  CANCER
 SCREENING  OR FOLLOW-UP DIAGNOSTIC IMAGING TO ASSIST IN THE DIAGNOSIS OF
 LUNG CANCER WHEN RECOMMENDED BY A HEALTH CARE PROVIDER ACTING WITHIN THE
 PROVIDER'S SCOPE OF PRACTICE PURSUANT TO TITLE EIGHT  OF  THE  EDUCATION
 LAW.
   (2)  NOTWITHSTANDING  ANY  OTHER  PROVISION  OF  LAW,  ANY POLICY THAT
 PROVIDES COVERAGE REQUIRED BY THIS SUBSECTION SHALL NOT IMPOSE A  COPAY-
 MENT,  COINSURANCE,  OR DEDUCTIBLE REQUIREMENT FOR LUNG CANCER SCREENING
 A. 6561                             3
 
 OR FOLLOW-UP DIAGNOSTIC IMAGING TO  ASSIST  IN  THE  DIAGNOSIS  OF  LUNG
 CANCER AND SHALL NOT REQUIRE PRIOR AUTHORIZATION FOR SUCH COVERAGE.
   § 7. This act shall take effect January 1, 2026 and shall apply to all
 policies  and contracts issued, renewed, modified, altered or amended on
 or after such date; provided, however, that if chapter 424 of  the  laws
 of 2024 shall not have taken effect on or before such date then sections
 one, two and three of this act shall take effect on the same date and in
 the same manner as such chapter of the laws of 2024 takes effect.

co-Sponsors

2025-A6561A (ACTIVE) - Details

See Senate Version of this Bill:: S6551
Current Committee:: Assembly Insurance
Law Section:: Insurance Law
Laws Affected:: Amd §§3216, 3221 & 4303, Ins L

2025-A6561A (ACTIVE) - Summary

Includes image-guided biopsies under mandatory insurance coverage for breast cancer screening.

2025-A6561A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6561--A
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                               March 6, 2025
                                ___________
 
 Introduced by M. of A. WEPRIN -- read once and referred to the Committee
   on  Insurance -- committee discharged, bill amended, ordered reprinted
   as amended and recommitted to said committee
 
 AN ACT to amend the insurance law, in relation to including image-guided
   biopsies under certain insurance coverage for breast cancer screening

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Item (iv) of subparagraph (A) of paragraph 11 of subsection
 (i)  of  section 3216 of the insurance law, as amended by chapter 424 of
 the laws of 2024, is amended to read as follows:
   (iv) upon the recommendation of a physician, screening and  diagnostic
 imaging,  including  diagnostic  mammograms,  breast ultrasounds, IMAGE-
 GUIDED BREAST BIOPSIES, or magnetic resonance  imaging,  recommended  by
 nationally  recognized clinical practice guidelines for the detection of
 breast cancer. For the purposes of  this  item,  "nationally  recognized
 clinical  practice  guidelines"  means  evidence-based clinical practice
 guidelines informed by a systematic review of evidence and an assessment
 of the benefits, and risks of alternative care options intended to opti-
 mize patient care developed  by  independent  organizations  or  medical
 professional societies utilizing a transparent methodology and reporting
 structure and with a conflict of interest policy.
   § 2. Item (v) of subparagraph (A) of paragraph 11 of subsection (l) of
 section 3221 of the insurance law, as amended by chapter 424 of the laws
 of 2024, is amended to read as follows:
   (v)  upon  the recommendation of a physician, screening and diagnostic
 imaging, including diagnostic  mammograms,  breast  ultrasounds,  IMAGE-
 GUIDED  BREAST  BIOPSIES,  or magnetic resonance imaging, recommended by
 nationally recognized clinical practice guidelines for the detection  of
 breast  cancer.  For  the  purposes of this item, "nationally recognized
 clinical practice guidelines"  means  evidence-based  clinical  practice
 guidelines informed by a systematic review of evidence and an assessment
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD10190-03-5

 A. 6561--A                          2
 
 of the benefits, and risks of alternative care options intended to opti-
 mize  patient  care  developed  by  independent organizations or medical
 professional societies utilizing a transparent methodology and reporting
 structure and with a conflict of interest policy.
   § 3. Subparagraph (E) of paragraph 1 of subsection (p) of section 4303
 of  the insurance law, as amended by chapter 424 of the laws of 2024, is
 amended to read as follows:
   (E) upon the recommendation of a physician, screening  and  diagnostic
 imaging,  including  diagnostic  mammograms,  breast ultrasounds, IMAGE-
 GUIDED BREAST BIOPSIES, or magnetic resonance  imaging,  recommended  by
 nationally  recognized clinical practice guidelines for the detection of
 breast cancer. For the purposes of this subparagraph, "nationally recog-
 nized clinical practice guidelines" means evidence-based clinical  prac-
 tice  guidelines  informed  by  a  systematic  review of evidence and an
 assessment of the  benefits,  and  risks  of  alternative  care  options
 intended to optimize patient care developed by independent organizations
 or  medical  professional  societies utilizing a transparent methodology
 and reporting structure and with a conflict of interest policy; and
   § 4. This act shall take effect January 1, 2026 and shall apply to all
 policies and contracts issued, renewed, modified, altered or amended  on
 or  after  such date; provided, however, that if chapter 424 of the laws
 of 2024 shall not have taken effect on or before such date then this act
 shall take effect on the same date and in the same manner as such  chap-
 ter of the laws of 2024 takes effect.

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