HOUSE DOCKET, NO. 3944 FILED ON: 1/14/2009
HOUSE . . . . . . . . . . . . . . . No. 1031
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The Commonwealth of Massachusetts
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In the Year Two Thousand Nine
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An Act Relative to providing insurance coverage for magnetic resonance imaging for certain persons..
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:
SECTION 1. Chapter 175 of the General Laws is hereby amended by inserting after section 47X the following section:-
Section 47Z. Any individual policy of accident and sickness insurance issued pursuant to section 108, and any group blanket policy of accident and sickness insurance issued pursuant to section 110, except policies providing supplemental coverage to Medicare or to other government programs, delivered, issued or renewed by agreement within or without the commonwealth shall provide coverage for Magnetic Resonance Imaging (MRI) for high risk women who are identified as those who have a personal history with cancer or, two or more first degree relatives with breast cancer or, early onset of breast cancer (before the age of 50) in one or more first degree relatives or, a history of breast cancer in more than one generation or, cancer in both breasts in one or more first degree relatives or, tested positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations or, have one or more first degree relatives test positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations or, have a personal history with Atypical Lobular Hyperplasia or Atypical Ductal Hyperplasia or Lobular Carcinoma in Situ. Said coverage will be provided once annually to women 25 years and older.
SECTION 2. Chapter l76A of the General Laws is hereby amended by inserting after section 8Y the following section:-
Section 8Z. Any contract, except contracts providing supplemental coverage to Medicare or other governmental programs, between a subscriber and the corporation under an individual or group hospital service plan which shall be delivered or issued or renewed in the commonwealth shall provide, as a basic benefit to all individual subscribers and members within the commonwealth and to all group members having a principal place of employment within the commonwealth, for expense for Magnetic Resonance Imaging (MRI) for high risk women who are identified as those who have a personal history with cancer or, two or more first degree relatives with breast cancer or, early onset of breast cancer (before the age of 50) in one or more first degree relatives or, a history of breast cancer in more than one generation or, cancer in both breasts in one or more first degree relatives or, tested positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations or, have one or more first degree relatives test positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations or, have a personal history with Atypical Lobular Hyperplasia or Atypical Ductal Hyperplasia or Lobular Carcinoma in Situ. Said Magnetic Resonance Imaging shall be provided in either a hospital or other setting and which shall meet standards promulgated by the commissioner of public health. Said coverage will be provided once annually to women 25 years and older.
SECTION 3. Chapter 176B of the General Laws is hereby amended by inserting after section 4Y the following section:-
Section 4Z. Any subscription certificate under an individual or group medical service agreement that shall be delivered, issued or renewed in the commonwealth shall provide as a benefit for all individual subscribers or members within the commonwealth and all group members having a principal place of employment within the commonwealth, coverage for expenses for Magnetic Resonance Imaging (MRI) for high risk women who are identified as those who have a personal history with cancer or, two or more first degree relatives with breast cancer or, early onset of breast cancer (before the age of 50) in one or more first degree relatives or, a history of breast cancer in more than one generation or, cancer in both breasts in one or more first degree relatives or, tested positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations or, have one or more first degree relatives test positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations or, have a personal history with Atypical Lobular Hyperplasia or Atypical Ductal Hyperplasia or Lobular Carcinoma in Situ and as authorized by a duly licensed physician. Said coverage will be provided once annually to women 25 years and older.
The benefits provided in this section shall meet all other terms and conditions within a subscription certificate. Medical service agreements shall not reduce or eliminate coverage due to the requirements of this section.