Requires insurance coverage of sonograms and other diagnostic procedures used to detect breast cancer for covered persons with a prior history of breast cancer or who have a first degree relative with a prior history of breast cancer.
Summary
Bill S00310 amends the New York insurance law to require that insurers provide coverage for certain breast cancer detection procedures. Specifically, it mandates coverage for mammograms, including breast tomosynthesis, for individuals with a prior history of breast cancer or those who have a first-degree relative with such a history. The bill also stipulates that a single baseline mammogram is covered for individuals aged 35 to 39, and annual mammograms are required for those aged 40 and older. Additionally, it includes provisions for coverage of other diagnostic imaging methods, such as breast ultrasounds and MRIs, based on physician recommendations and established clinical guidelines.
Impact
The bill will enhance insurance coverage for breast cancer detection in New York, particularly for individuals at higher risk due to personal or familial history. This change aims to improve early detection and potentially reduce breast cancer mortality rates among the affected populations. It modifies existing insurance law to ensure that necessary diagnostic procedures are accessible and covered by insurers, thereby impacting both insurance providers and policyholders.
Sentiment
The sentiment surrounding Bill S00310 appears to be generally supportive, as it addresses critical health needs for individuals at risk of breast cancer. Discussions in committee have highlighted the importance of early detection and the need for comprehensive insurance coverage. However, there may be concerns from insurers regarding the potential increase in costs associated with expanded coverage requirements.
Contention
Notable points of contention may arise from insurance companies regarding the financial implications of the expanded coverage requirements. Some stakeholders may argue about the balance between providing necessary health services and managing insurance costs. Additionally, there could be discussions about the adequacy of the proposed clinical guidelines and their implications for coverage determinations.
Requires insurance coverage of sonograms and other diagnostic procedures used to detect breast cancer for covered persons with a prior history of breast cancer or who have a first degree relative with a prior history of breast cancer.
Requires insurance coverage of sonograms and other diagnostic procedures used to detect breast cancer for covered persons with a prior history of breast cancer or who have a first degree relative with a prior history of breast cancer.
Requires health insurance coverage for mammography by either mammogram and breast ultrasound or breast tomosynthesis for persons with heterogeneously dense or extremely dense breasts.
Requires health care professional to order bi-lateral ultrasounds concurrently when ordering mammograms; requires insurers to cover concurrent mammograms and bi-lateral ultrasounds.
Requires health care professionals to order bi-lateral ultrasounds concurrently when ordering mammograms; requires insurers to cover concurrent mammograms and bi-lateral ultrasounds.