On first day of Breast Cancer Awareness Month, Hochul signs legislation to expand insurance coverage of breast cancer screening & imaging

Legislation S.2465C/A.1696C expands insurance coverage of breast cancer screening and imaging to include nationally recognized guidelines

Submitted by the Office of Gov. Kathy Hochul

On the first day of Breast Cancer Awareness Month, Gov. Kathy Hochul 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,” 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 nonprofit (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 Sen. 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.”

Assembly member 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.”