On the first day of Breast Cancer Awareness Month, Governor Hochul signed legislation to expand coverage of cancer screening and imaging to reflect recognized industry guidelines. Legislation S.2465C/A.1696C Expands Insurance Coverage of Breast Cancer Screening and Imaging To Include Nationally Recognized Guidelines
On the first day of Breast Cancer Awareness Month, Governor Kathy Hochul today ( October 1. 2024 ) signed legislation to expand insurance coverage of breast cancer screening and imaging to include procedures as recommended by nationally recognized clinical practice guidelines for the detection of breast cancer.
“Every woman in New York State should have access to the full scope of coverage options for breast cancer screening and imaging, which is key to early diagnosis and treatment,” Governor Hochul said. “This legislation ensures that critical preventative services are available without financial constraint – saving lives and setting a new standard of care for New Yorkers.”
Legislation S.2465C/A.1696C changes parts of the Insurance Law to require individual, group, and non-profit (including HMO) health insurance plans to cover breast cancer screening and diagnostic imaging. This coverage applies if a doctor recommends it based on nationally recognized clinical guidelines. The screenings include diagnostic mammograms, breast ultrasounds, and MRIs.
The legislation also clarifies that cost-sharing will not apply to these procedures except to the extent it would result in health savings account ineligibility under IRS guidelines.
The legislation defines “nationally recognized clinical practice guidelines” to include evidence-based standards developed by independent organizations or medical professional societies using a transparent methodology and reporting structure.
State Senator Roxanne J. Persaud said, “With the signing of this critical legislation, we take a significant step forward in the fight against breast cancer. This expansion of insurance coverage for screenings and imaging will empower individuals to prioritize their health without the burden of cost and ensure that early detection becomes a standard, not a privilege. I thank my colleague Assembly Member Hunter for joining me in the advocacy and Governor Hochul for signing this legislation.”
Assemblymember Pamela J. Hunter said, “Expanding insurance coverage for breast cancer screening and imaging based on nationally recognized clinical guidelines is a vital step in ensuring that women across New York have access to lifesaving early detection. This legislation, signed during Breast Cancer Awareness Month, removes financial barriers to critical diagnostic procedures like mammograms, ultrasounds and MRIs, which are essential in the fight against breast cancer. I am proud to have championed this bill in the Assembly, and I want to thank Governor Hochul and Senator Persaud for their leadership and support in making this a reality for women across the state.”
October 1, 2024 Albany, New York
Questions from Critics:
Republicans:
- How will the state ensure that this expanded coverage does not lead to increased insurance premiums for consumers?
- What measures are in place to evaluate the long-term effectiveness of this legislation in improving breast cancer detection rates?
Democrats:
- How does the state plan to educate women about the newly expanded coverage and encourage them to utilize these critical screening services?
- Will there be ongoing oversight to ensure compliance with these guidelines across all insurance providers in New York?
Sources: New York State NY.gov , Midtown Tribune news,
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