2014 -- H 7341

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LC004154

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

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A N   A C T

RELATING TO INSURANCE - HEALTH AND SAFETY - THE BREAST CANCER ACT

     Introduced By: Representatives E Coderre, Tanzi, Ackerman, Ajello, and Walsh

     Date Introduced: February 06, 2014

     Referred To: House Corporations

     It is enacted by the General Assembly as follows:

     SECTION 1. Chapter 23-12.7 of the General Laws entitled "The Breast Cancer Act" is

hereby amended by adding thereto the following section:

     23-12.7-4. Ultrasound Breast Cancer detection- Notice - Coverage mandated.--

(a) Commencing on October 1, 2014, each mammography report provided to a patient

shall include information about breast density, based on the Breast Imaging Reporting and Data

System established by the American College of Radiology. Where applicable, such report shall

include the following notice: "If your mammogram demonstrates that you have dense breast

tissue, which could hide small abnormalities, you might benefit from supplementary screening

tests, which can include a breast ultrasound screening or a breast MRI examination, or both,

depending on your individual risk factors. A report of your mammography results, which contains

information about your breast density, has been sent to your physician's office and you should

contact your physician if you have any questions or concerns about this report."

     (b) Every individual or group hospital or medical expense insurance policy or individual

or group hospital or medical services plan contract delivered, issued for delivery, or renewed in

this state shall provide coverage for comprehensive ultrasound screening of an entire breast or

breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast

Imaging Reporting and Data System established by the American College of Radiology or if a

woman is believed to be at increased risk for breast cancer due to family history or prior personal

history of breast cancer, positive genetic testing or other indications as determined by a woman's

physician or advanced practice registered nurse. Provided, this section does not apply to

insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability

income; (3) Accident only: (4) Long-term care: (5) Medicare supplement; (6) Limited benefit

health: (7) Specific disease indemnity; (8) Sickness or bodily injury or death by accident or both;

and (9) Other limited benefit policies.

     SECTION 2. Chapter 27-18 of the General Laws entitled "Accident and Sickness

Insurance Policies" is hereby amended by adding thereto the following section:

     27-18-82. Ultrasound Breast Cancer detection- Notice - Coverage mandated.--

(a) Commencing on October 1, 2014, each mammography report provided to a patient

shall include information about breast density, based on the Breast Imaging Reporting and Data

System established by the American College of Radiology. Where applicable, such report shall

include the following notice: "If your mammogram demonstrates that you have dense breast

tissue, which could hide small abnormalities, you might benefit from supplementary screening

tests, which can include a breast ultrasound screening or a breast MRI examination, or both,

depending on your individual risk factors. A report of your mammography results, which contains

information about your breast density, has been sent to your physician's office and you should

contact your physician if you have any questions or concerns about this report."

     (b) Every individual or group hospital or medical expense insurance policy or individual

or group hospital or medical services plan contract delivered, issued for delivery, or renewed in

this state shall provide coverage for comprehensive ultrasound screening of an entire breast or

breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast

Imaging Reporting and Data System established by the American College of Radiology or if a

woman is believed to be at increased risk for breast cancer due to family history or prior personal

history of breast cancer, positive genetic testing or other indications as determined by a woman's

physician or advanced practice registered nurse. Provided, this section does not apply to

insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability

income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit

health; (7) Specific disease indemnity; (8) Sickness or bodily injury or death by accident or both;

and (9) Other limited benefit policies.

     SECTION 3. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

Corporations" is hereby amended by adding thereto the following section:

     27-19-73. Ultrasound Breast Cancer detection - Notice - Coverage mandated.--

(a) Commencing on October 1, 2014, each mammography report provided to a patient

shall include information about breast density, based on the Breast Imaging Reporting and Data

LC004154 - Page 2 of 6

System established by the American College of Radiology. Where applicable, such report shall

include the following notice: "If your mammogram demonstrates that you have dense breast

tissue, which could hide small abnormalities, you might benefit from supplementary screening

tests, which can include a breast ultrasound screening or a breast MRl examination, or both,

depending on your individual risk factors. A report of your mammography results, which contains

information about your breast density, has been sent to your physician's office and you should

contact your physician if you have any questions or concerns about this report."

     (b) Every individual or group hospital or medical expense insurance policy or individual

or group hospital or medical services plan contract delivered, issued for delivery, or renewed in

this state shall provide coverage for comprehensive ultrasound screening of an entire breast or

breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast

Imaging Reporting and Data System established by the American College of Radiology or if a

woman is believed to be at increased risk for breast cancer due to family history or prior personal

history of breast cancer, positive genetic testing or other indications as determined by a woman's

physician or advanced practice registered nurse. Provided, this section does not apply to

insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability

income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit

health; (7) Specific disease indemnity; (8) Sickness or bodily injury or death by accident or both;

and (9) Other limited benefit policies.

     SECTION 4. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

Corporations" is hereby amended by adding thereto the following section:

     27-20-69. Ultrasound Breast Cancer detection- Notice - Coverage mandated.--

      (a) Commencing on October 1. 2014, each mammography report provided to a patient

shall include information about breast density, based on the Breast Imaging Reporting and Data

System established by the American College of Radiology. Where applicable, such report shall

include the following notice: "If your mammogram demonstrates that you have dense breast

tissue, which could hide small abnormalities, you might benefit from supplementary screening

tests, which can include a breast ultrasound screening or a breast MRI examination, or both,

depending on your individual risk factors. A report of your mammography results, which contains

information about your breast density, has been sent to your physician's office and you should

contact your physician if you have any questions or concerns about this report."

     (b) Every individual or group hospital or medical expense insurance policy or individual

or group hospital or medical services plan contract delivered, issued for delivery, or renewed in

this state shall provide coverage for comprehensive ultrasound screening of an entire breast or

LC004154 - Page 3 of 6

breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast

Imaging Reporting and Data System established by the American College of Radiology or if a

woman is believed to be at increased risk for breast cancer due to family history or prior personal

history of breast cancer, positive genetic testing or other indications as determined by a woman's

physician or advanced practice registered nurse. Provided, this section does not apply to

insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability

income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit

health; (7) Specific disease indemnity; (8) Sickness or bodily injury or death by accident or both;

and (9) Other limited benefit policies.

     SECTION 5. Chapter 27-19 of the General Laws entitled "Accident and Sickness

Insurance Policies" is hereby amended by adding thereto the following section:

     27-19-73. Ultrasound Breast Cancer detection -Notice - Coverage mandated.--

(a) Commencing on October 1. 2014, each mammography report provided to a patient

shall include information about breast density, based on the Breast Imaging Reporting and Data

System established by the American College of Radiology. Where applicable, such report shall

include the following notice: "If your mammogram demonstrates that you have dense breast

tissue, which could hide small abnormalities, you might benefit from supplementary screening

tests, which can include a breast ultrasound screening or a breast MRl examination, or both,

depending on your individual risk factors. A report of your mammography results, which contains

information about your breast density, has been sent to your physician's office and you should

contact your physician if you have any questions or concerns about this report."

     (b) Every individual or group hospital or medical expense insurance policy or individual

or group hospital or medical services plan contract delivered, issued for delivery, or renewed in

this state shall provide coverage for comprehensive ultrasound screening of an entire breast or

breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast

Imaging Reporting and Data System established by the American College of Radiology or if a

woman is believed to be at increased risk for breast cancer due to family history or prior personal

history of breast cancer positive genetic testing or other indications as determined by a woman's

physician or advanced practice registered nurse. Provided, this section does not apply to

insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability

income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit

health; (7) Specific disease indemnity; (8) Sickness or bodily injury or death by accident or both:

and (9) Other limited benefit policies.

     SECTION 6. Chapter 27-41 of the General Laws entitled "Health Maintenance

LC004154 - Page 4 of 6

Organizations" is hereby amended by adding thereto the following section:

     27-41-86. Ultrasound Breast Cancer detection - Notice- Coverage mandated.--

      (a) Commencing on October 1. 2014, each mammography report provided to a patient

shall include information about breast density, based on the Breast Imaging Reporting and Data

S)'stem established by the American College of Radiology. Where applicable, such report shall

include the following notice: "If your mammogram demonstrates that you have dense breast

tissue which could hide small abnormalities, you might benefit from supplementary screening

tests, which can include a breast ultrasound screening or a breast MRI examination, or both

depending on your individual risk factors. A report of your mammography results, which contains

information about your breast density, has been sent to your physician's office and you should

contact your physician if you have any questions or concerns about this report."

     (b) Every individual or group hospital or medical expense insurance policy or individual

or group hospital or medical services plan contract delivered, issued for delivery, or renewed in

this state shall provide coverage for comprehensive ultrasound screening of an entire breast or

breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast

Imaging Reporting and Data System established by the American College of Radiology or if a

woman is believed to be at increased risk for breast cancer due to family history or prior personal

history of breast cancer, positive genetic testing or other indications as determined by a woman's

physician or advanced practice registered nurse. Provided, this section does not apply to

insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability

income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit

health; (7) Specific disease indemnity; (8) Sickness or bodily injury or death by accident or both;

and (9) Other limited benefit policies.

     SECTION 7. This act shall take effect on October 1, 2014.

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LC004154

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE - HEALTH AND SAFETY - THE BREAST CANCER ACT

***

     This act would require that each mammography report given to a patient must include

information about the patient's breast density and to advise that under certain circumstances the

patient may benefit from a breast ultrasound screening. In addition, most insurance policies shall

be required to provide coverage for the ultrasound screening.

     This act would take effect on October 1, 2014.

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LC004154

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