2019 -- S 0579

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LC001805

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO HEALTH AND SAFETY -- THE BREAST CANCER ACT

     

     Introduced By: Senators Coyne, Euer, Goldin, Valverde, and Crowley

     Date Introduced: March 14, 2019

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. Section 23-12.7-3 of the General Laws in Chapter 23-12.7 entitled "The

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Breast Cancer Act" is hereby amended to read as follows:

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     23-12.7-3. Program established.

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     (a) Through funding from the Rhode Island Cancer Council, the Rhode Island department

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of health is required to establish a program of free mammography and digital breast

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tomosynthesis (dbt) screening according to American Cancer Society standards, and, where

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required, follow-up, diagnostic testing, and case management for women in the state who are

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uninsured or underinsured.

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     (b) The screening program shall:

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     (1) Secure radiology facilities to participate in the screening program;

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     (2) Pay for screening mammograms and digital breast tomosynthesis (dbt) screenings;

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     (3) Ensure that screening results are sent directly to the patient in a timely manner;

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     (4) Provide diagnostic tests as required to diagnose breast cancer;

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     (5) Provide case management facilitating appropriate contact to breast surgeons, medical

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oncologists, and radiation oncologists; and

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     (6) Provide follow-up support to women who are found to have breast cancer as a result

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of this screening program.

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     (c) The director of the Rhode Island department of health is required to provide a

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quarterly report to the general assembly on the program of free mammography screening, follow

 

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up diagnostic testing and case management, and public education. An advisory committee

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concerned with advocacy, outreach, and public education shall meet on a quarterly basis and

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report to the director.

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     SECTION 2. Section 23-12.9-2 of the General Laws in Chapter 23-12.9 entitled "Dense

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Breast Notification and Education" is hereby amended to read as follows:

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     23-12.9-2. Public policy goals -- Department of health.

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     The department of health, through the Rhode Island Cancer Council, is authorized and

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mandated to implement the following public health policy goals as they relate to dense breast

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notification in Rhode Island. Commencing on October 1, 2014, all health care facilities that

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perform mammography examinations and digital breast tomosynthesis (dbt) screenings shall

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include in the summary of the mammography report to be provided to a patient, information that

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identifies the patient's individual Breast Tissue Classification based on the Breast Imaging

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Reporting and Data System established by the American College of Radiology. If the facility

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determines that a patient has heterogeneously or extremely dense breasts, the summary of the

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mammography report shall also include the following notice:

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     "Your mammogram indicates that you have dense breast tissue. Dense breast tissue is

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relatively common and is found in about forty percent (40%) of women. The presence of dense

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tissue can make it more difficult to detect cancers in the breast by mammography because it can

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hide small abnormalities and may be associated with an increased risk. Hence, you may benefit

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from supplementary screening tests, which may include a breast ultrasound screening, or a breast

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MRI examination, or both, depending on your individual risk factors.

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     We are providing this information to raise your awareness of this important factor and to

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encourage you to discuss your dense breast tissue, as well as other breast cancer risk factors, with

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your health care provider. Together, you can decide which screening options are right for you.

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     A report of your results was sent to your physician. You should contact your physician if

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you have any questions or concerns about this report."

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     SECTION 3. Section 23-17-32 of the General Laws in Chapter 23-17 entitled "Licensing

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of Health-Care Facilities" is hereby amended to read as follows:

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     23-17-32. Mammograms -- Quality assurance standards Mammograms and digital

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breast tomosynthesis (dbt) -- Quality assurance standards.

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     Any licensed health care facility performing a mammogram shall meet state-approved

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quality assurance standards for taking and processing mammograms and digital breast

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tomosynthesis (dbt) screenings. The director of health shall have the authority to promulgate rules

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and regulations necessary to carry out the provisions of this section.

 

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     SECTION 4. Section 27-18-41 of the General Laws in Chapter 27-18 entitled "Accident

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and Sickness Insurance Policies" is hereby amended to read as follows:

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     27-18-41. Mammograms and pap smears -- Coverage mandated Mammograms,

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digital breast tomosynthesis (dbt) and pap smears -- Coverage mandated.

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     (a)(1) Every individual or group hospital or medical expense insurance policy or

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

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renewed in this state shall provide coverage for mammograms, and digital breast tomosynthesis

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(dbt) screenings, and pap smears, in accordance with guidelines established by the American

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Cancer Society.

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     (2) Notwithstanding the provisions of this chapter, every individual or group hospital or

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medical insurance policy or individual or group hospital or medical services plan contract

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delivered, issued for delivery, or renewed in this state shall pay for two (2) screening

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mammograms per year when recommended by a physician for women who have been treated for

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breast cancer within the last five (5) years or are at high risk of developing breast cancer due to

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genetic predisposition (BRCA gene mutation or multiple first degree relatives) or high risk lesion

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on prior biopsy (lobular carcinoma in situ) or atypical ductal hyperplasia.

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     (b) This section shall not apply to insurance coverage providing benefits for: (1) hospital

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confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare

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supplement; (6) limited benefit health; (7) specified disease indemnity; (8) sickness or bodily

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injury or death by accident or both; and (9) other limited benefit policies.

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     SECTION 5. Section 27-19-20 of the General Laws in Chapter 27-19 entitled "Nonprofit

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Hospital Service Corporations" is hereby amended to read as follows:

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     27-19-20. Mammograms and pap smears -- Coverage mandated Mammograms,

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digital breast tomosynthesis (dbt) and pap smears -- Coverage mandated.

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     (a) Subscribers to any nonprofit hospital service plan shall be afforded coverage under

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the plan for mammograms, and digital breast tomosynthesis (dbt) screenings, and pap smears, in

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accordance with guidelines established by the American Cancer Society.

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     (b) Notwithstanding the provisions of this chapter, subscribers to any nonprofit hospital

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service plan shall be afforded coverage for two (2) screening mammograms per year when

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recommended by a physician for women who have been treated for breast cancer within the last

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five (5) years or who are at high risk of developing breast cancer due to genetic predisposition

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(BRCA gene mutation or multiple first degree relatives) or high risk lesion on prior biopsy

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(lobular carcinoma in situ) or atypical ductal hyperplasia.

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     SECTION 6. Section 27-20-17 of the General Laws in Chapter 27-20 entitled "Nonprofit

 

LC001805 - Page 3 of 6

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Medical Service Corporations" is hereby amended to read as follows:

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     27-20-17. Mammograms and pap smears -- Coverage mandated Mammograms,

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digital breast tomosynthesis (dbt) and pap smears -- Coverage mandated.

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     (a) Subscribers to any nonprofit medical service plan shall be afforded coverage under

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the plan for mammograms, and digital breast tomosynthesis (dbt) screenings, and pap smears, in

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accordance with guidelines established by the American Cancer Society.

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     (b) Notwithstanding the provisions of this chapter, subscribers to any nonprofit medical

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service plan shall be afforded coverage for two (2) paid screening mammograms per year when

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recommended by a physician for women who have been treated for breast cancer within the last

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five (5) years or who are at high risk of developing breast cancer due to genetic predisposition

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(BRCA gene mutation or multiple first degree relatives) or high risk lesion on prior biopsy

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(lobular carcinoma in situ) or atypical ductal hyperplasia.

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     SECTION 7. Section 27-41-30 of the General Laws in Chapter 27-41 entitled "Health

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Maintenance Organizations" is hereby amended to read as follows:

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     27-41-30. Mammograms and pap smears -- Coverage mandated Mammograms,

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digital breast tomosynthesis (dbt) and pap smears -- Coverage mandated.

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     (a) Subscribers to any health maintenance organization plan shall be afforded coverage

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under that plan for mammograms, and digital breast tomosynthesis (dbt) screenings, and pap

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smears, in accordance with guidelines established by the American Cancer Society.

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     (b) Notwithstanding the provisions of this chapter, subscribers to any health maintenance

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organization plan shall be afforded coverage for two (2) paid screening mammograms per year

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when recommended by a physician for women who have been treated for breast cancer within the

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last five (5) years or who are at high risk of developing breast cancer due to genetic

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predisposition (BRCA gene mutation or multiple first degree relatives) or high risk lesion on prior

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biopsy (lobular carcinoma in situ) or atypical ductal hyperplasia.

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     SECTION 8. Section 42-62-26 of the General Laws in Chapter 42-62 entitled

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"Catastrophic Health Insurance Plan Act" is hereby amended to read as follows:

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     42-62-26. Mammograms and pap smears -- Coverage mandated Mammograms,

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digital breast tomosynthesis (dbt) and pap smears -- Coverage mandated.

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     Any insurer, as defined in this chapter, shall afford health insurance coverage for

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mammograms, and digital breast tomosynthesis (dbt) screenings, and Pap smears, in accordance

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with guidelines established by the American Cancer Society.

 

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     SECTION 9. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- THE BREAST CANCER ACT

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     This act would amend the current law so that digital breast tomosynthesis (dbt)

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screenings are available wherever mammograms are conducted and to provide insurance

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coverage for such screenings.

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     This act would take effect upon passage.

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