New York S 2395: Requires health insurance coverage for mammography by either mammogram and breast ultrasound or breast tomosynthesis for persons with certain breast densities

Bill Text

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S02395 Summary:

BILL NOS02395 

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SAME ASSAME AS A08505

&nbsp

SPONSORPERSAUD

&nbsp

COSPNSRCLEARE, COMRIE, GONZALEZ, SCARCELLA-SPANTON

&nbsp

MLTSPNSR

&nbsp

Amd §§3216, 3221 & 4303, Ins L

&nbsp

Requires health insurance coverage for mammography by either mammogram and breast ultrasound or breast tomosynthesis for persons with heterogeneously dense or extremely dense breasts.

Go to top S02395 Actions:

BILL NOS02395 

&nbsp

01/17/2025REFERRED TO INSURANCE

01/07/2026REFERRED TO INSURANCE

Go to topS02395 Committee&nbspVotes:

Go to topS02395 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topS02395 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 2395

 2025-2026 Regular Sessions

 IN SENATE

 January 17, 2025
 ___________

 Introduced by Sen. PERSAUD -- read twice and ordered printed, and when
 printed to be committed to the Committee on Insurance

 AN ACT to amend the insurance law, in relation to requiring health
 insurance coverage for mammography by either mammogram and breast
 ultrasound or breast tomosynthesis for persons with certain breast
 densities

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Subparagraph (A) of paragraph 11 of subsection (i) of
 2 section 3216 of the insurance law, as amended by chapter 414 of the laws
 3 of 2017, is amended to read as follows:
 4 (A) Every policy that provides coverage for hospital, surgical or
 5 medical care shall provide the following coverage for mammography
 6 screening for occult breast cancer:
 7 (i) upon the recommendation of a physician, a mammogram, which may be
 8 provided by breast tomosynthesis, at any age for covered persons having
 9 a prior history of breast cancer or who have a first degree relative
 10 with a prior history of breast cancer;
 11 (ii) a single baseline mammogram, which may be provided by breast
 12 tomosynthesis, for covered persons aged thirty-five through thirty-nine,
 13 inclusive; [and]
 14 (iii) an annual mammogram, which may be provided by breast tomosynthe-
 15 sis, for covered persons aged forty and older; and
 16 (iv) either: a. an annual mammogram and breast ultrasound; or b.
 17 breast tomosynthesis for covered persons with heterogeneously dense or
 18 extremely dense breasts.
 19 § 2. Subparagraph (A) of paragraph 11 of subsection (i) of section
 20 3216 of the insurance law, as amended by chapter 424 of the laws of
 21 2024, is amended to read as follows:
 22 (A) Every policy that provides coverage for hospital, surgical or
 23 medical care shall provide the following coverage for mammography
 24 screening for occult breast cancer:
 25 (i) upon the recommendation of a physician, a mammogram, which may be
 26 provided by breast tomosynthesis, at any age for covered persons having

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD06157-01-5

 S. 2395 2

 1 a prior history of breast cancer or who have a first degree relative
 2 with a prior history of breast cancer;
 3 (ii) a single baseline mammogram, which may be provided by breast
 4 tomosynthesis, for covered persons aged thirty-five through thirty-nine,
 5 inclusive;
 6 (iii) an annual mammogram, which may be provided by breast tomosynthe-
 7 sis, for covered persons aged forty and older; [and]
 8 (iv) upon the recommendation of a physician, screening and diagnostic
 9 imaging, including diagnostic mammograms, breast ultrasounds, or magnet-
 10 ic resonance imaging, recommended by nationally recognized clinical
 11 practice guidelines for the detection of breast cancer. For the purposes
 12 of this item, "nationally recognized clinical practice guidelines" means
 13 evidence-based clinical practice guidelines informed by a systematic
 14 review of evidence and an assessment of the benefits, and risks of
 15 alternative care options intended to optimize patient care developed by
 16 independent organizations or medical professional societies utilizing a
 17 transparent methodology and reporting structure and with a conflict of
 18 interest policy; and
 19 (v) either: a. an annual mammogram and breast ultrasound; or b. breast
 20 tomosynthesis for covered persons with heterogeneo