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.
Summary
Bill S03559 amends the public health law to allow a notice of dense breast tissue from mammography services to be considered a determination of medical necessity for the coverage of breast ultrasounds. This change aims to enhance patient awareness regarding the implications of dense breast tissue, which can complicate the detection of breast cancer and may increase the associated risk. The bill mandates that patients receive specific information about their breast density along with recommendations for further screening tests based on their individual risk factors.
Impact
The bill impacts state laws by ensuring that patients with dense breast tissue are provided with essential information that may lead to additional screening, thereby potentially improving early detection of breast cancer. It also establishes a precedent for insurance coverage of breast ultrasounds when a notice of dense breast tissue is provided, which could influence how insurance providers assess medical necessity in similar cases.
Sentiment
The general sentiment around Bill S03559 appears to be supportive, as evidenced by unanimous votes in the Senate Health Committee, indicating a consensus on the importance of addressing breast cancer risks associated with dense breast tissue. The discussions have highlighted the need for better patient education and access to necessary screenings.
Contention
While there seems to be broad support for the bill, potential points of contention could arise regarding insurance companies' responses to the new coverage requirements. Some stakeholders may express concerns about the financial implications for insurers and the healthcare system, particularly regarding the increased demand for breast ultrasounds and the associated costs.
Same As
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.
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.
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.
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.
Requires health insurance coverage for mammography by either mammogram and breast ultrasound or breast tomosynthesis for persons with heterogeneously dense or extremely dense breasts.
Insurance; utilization review by an insurer shall not be required in the instance in which a physician has determined the existence of dense breast tissue and the medical necessity of a breast ultrasound; provide
In casualty insurance, repealing provisions relating to coverage for mammographic examinations and breast imaging and providing for coverage for mammographic examinations, magnetic resonance imaging and other forms of breast imaging.