Bill Text: NY A02516 | 2023-2024 | General Assembly | Amended

---

Bill Title: 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.

Spectrum: Partisan Bill (Democrat 2-0)

Status: (Introduced - Dead) 2024-03-06 - print number 2516a [A02516 Detail]

Download: New_York-2023-A02516-Amended.html

---

                STATE OF NEW YORK
        ________________________________________________________________________

                                         2516--A

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                    January 26, 2023
                                       ___________

        Introduced  by  M.  of A. PAULIN, SEAWRIGHT -- read once and referred to
          the Committee on Insurance -- recommitted to the Committee  on  Insur-
          ance  in  accordance  with  Assembly  Rule  3,  sec.  2  --  committee
          discharged, bill amended, ordered reprinted as amended and recommitted
          to said committee

        AN ACT to amend the public health law, in relation to allowing a  notice
          of  dense  breast  tissue  to be considered a determination of medical
          necessity for coverage of a breast ultrasound

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

     1    Section  1. Section 2404-c of the public health law, as added by chap-
     2  ter 265 of the laws of 2012, is amended to read as follows:
     3    § 2404-c. Breast cancer; duty of providers of mammography services  to
     4  notify and inform. 1. Every provider of mammography services shall, if a
     5  patient's  mammogram demonstrates dense breast tissue, provide notifica-
     6  tion to such patient that shall include, but  not  be  limited  to,  the
     7  following  information,  in  any summary of the mammography report sent,
     8  pursuant to the  federal  mammography  quality  standards  act,  to  the
     9  patient:
    10    Your  mammogram  shows  that your breast tissue is dense. Dense breast
    11  tissue is very common and is not abnormal. However, dense breast  tissue
    12  can make it harder to find cancer on a mammogram and may also be associ-
    13  ated with an increased risk of breast cancer.
    14    This information about the result of your mammogram is given to you to
    15  raise  your awareness. Use this information to talk to your doctor about
    16  your own risks for breast cancer. At that time, ask your doctor if  more
    17  screening  tests  might  be useful, based on your risk. A report of your
    18  results was sent to your physician.
    19    For the purposes of this section dense breast tissue shall mean heter-
    20  ogeneously dense or extremely dense  tissue  as  defined  in  nationally
    21  recognized guidelines or systems for breast imaging reporting of mammog-

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD05349-02-4
        A. 2516--A                          2

     1  raphy  screening,  including,  but  not  limited  to, the breast imaging
     2  reporting and data system of the American College of Radiology, and  any
     3  equivalent new terms, as such guidelines or systems are updated.
     4    2.  Where  a provider of mammography services has provided notice to a
     5  patient under subdivision one of  this  section,  the  notice  shall  be
     6  considered a determination of medical necessity for purposes of coverage
     7  of a breast ultrasound.
     8    § 2.  This act shall take effect immediately.