What's happening
Shannon's Law requires large group health insurance policies in New York to cover annual mammograms for people aged 35-39 if medically necessary.
Why it matters
Addresses a gap in early breast cancer detection. by requiring insurance coverage for annual mammograms for people aged 35-39 when a doctor deems it medically necessary, rather than only allowing a single baseline scan in that age group. This could potentially lead to earlier diagnosis and better outcomes for younger individuals at risk.
Limits out-of-pocket costs for patients. , as the bill specifies that these annual mammograms (if deemed medically necessary) cannot be subject to annual deductibles or coinsurance, making the screenings more financially accessible.
Applies specifically to large group health insurance policies. , meaning employees covered by such plans will benefit from expanded preventive care, while not affecting individual or small group policies.
Relies on physician recommendation and medical necessity. , so the coverage is not automatic for everyone aged 35-39, but is targeted to those with risk factors or clinical indications, aiming to balance broader access with appropriate use of resources.
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Who cares
Headline styles
Expand Mammogram Insurance Coverage
Plain English, a few words. Used as the page title.
Sponsors
23 Co-sponsors
- Vivian Cook
- Latrice Walker
- William Colton
- Ellen C. Jaffee
- Alicia Hyndman
- Inez E. Dickens
- Kenneth Zebrowski
- Jo Anne Simon
- Anthony D'Urso
- Nily Rozic
- Thomas Abinanti
- Michael Blake
- David McDonough
- Melissa Miller
- Anthony H. Palumbo
- Tremaine Wright
- Latoya Joyner
- Karl Brabenec
- Andrew R. Garbarino
- Mike LiPetri
- Michele Titus
- Andrew Raia
- Linda Rosenthal
1 Multi-sponsor
History
- Substituted by S3852A
- Ordered to third reading rules cal.268
- Rules report cal.268
- Reported
- Reported referred to rules
- Print number 5502a
- Amend and recommit to ways and means
- Reported referred to ways and means
- Reported referred to codes
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Expand Mammogram Coverage Age
Signed by Governor · Sponsor Monica Martinez
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
5502--A
2019-2020 Regular Sessions
IN ASSEMBLY
February 13, 2019
Introduced by M. of A. JEAN-PIERRE, COOK, WALKER, COLTON, JAFFEE, HYND- MAN, DICKENS, ZEBROWSKI, SIMON, D'URSO, ROZIC, ABINANTI, BLAKE, McDO- NOUGH, M. L. MILLER, PALUMBO, WRIGHT, JOYNER, BRABENEC, GARBARINO, LiPETRI, TITUS, RAIA -- Multi-Sponsored by -- M. of A. THIELE -- read once and referred to the Committee on Insurance -- reported and referred to the Committee on Codes -- reported and referred to the Committee on Ways and Means -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee
AN ACT to amend the insurance law, in relation to enacting "Shannon's Law"
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Short title. This act shall be known and may be cited as "Shannon's Law".
§ 2. Subparagraph (A) of paragraph 11 of subsection (l) of section 3221 of the insurance law, as amended by chapter 414 of the laws of 2017, is amended to read as follows:
(A) Every insurer delivering a group or blanket policy or issuing a group or blanket policy for delivery in this state that provides coverage for hospital, surgical or medical care shall provide the following coverage for mammography screening for occult breast cancer:
(i) upon the recommendation of a physician, a mammogram, which may be provided by breast tomosynthesis, at any age for covered persons having a prior history of breast cancer or who have a first degree relative with a prior history of breast cancer;
(ii) a single baseline mammogram, which may be provided by breast tomosynthesis, for covered persons aged thirty-five through thirty-nine, inclusive; [and]
(iii) an annual mammogram, which may be provided by breast tomosynthesis, for covered persons aged forty and older[.]; and
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD09044-03-9
A. 5502--A 2
(iv) for large group policies that provide coverage for hospital, surgical or medical care, an annual mammogram for covered persons aged thirty-five through thirty-nine, inclusive, upon the recommendation of a physician, subject to the insurer's determination that the mammogram is medically necessary.
§ 3. Subparagraphs (B), (C) and (D) of paragraph 1 of subsection (p) of section 4303 of the insurance law, subparagraphs (B) and (C) as amended by chapter 414 of the laws of 2017, subparagraph (D) as amended by chapter 74 of the laws of 2016, are amended to read as follows:
(B) a single baseline mammogram, which may be provided by breast tomosynthesis, for covered persons aged thirty-five through thirty-nine, inclusive; [and]
(C) an annual mammogram, which may be provided by breast tomosythesis, for covered persons aged forty and older[.];
(D) for large group contracts offered by a medical expense indemnity corporation, a hospital service corporation or a health service corporation that provide coverage for hospital, surgical or medical care, an annual mammogram for covered persons aged thirty-five through thirtynine, inclusive, upon the recommendation of a physician, subject to the corporation's determination that the mammogram is medically necessary; and
(E) The coverage required in this paragraph or paragraph two of this subsection shall not be subject to annual deductibles or coinsurance.
§ 4. This act shall take effect on the thirtieth day after it shall have become a law, and shall apply to policies and contracts issued, renewed, modified, altered or amended on or after such effective date.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.