HOUSE DOCKET, NO. 2624        FILED ON: 1/16/2015

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 938

The Commonwealth of Massachusetts

_________________

PRESENTED BY:

Tom Sannicandro

_________________

To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:

The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:

An Act relative to providing insurance coverage for breast cancer screening.

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PETITION OF:

HOUSE DOCKET, NO. 2624        FILED ON: 1/16/2015

HOUSE  .  .  .  .  .  .  .  .  .  .  .  .  .  .  .  No. 938

[SIMILAR MATTER FILED IN PREVIOUS SESSION
SEE HOUSE, NO. 974 OF 2013-2014.]

The Commonwealth of Massachusetts

_______________

In the One Hundred and Eighty-Ninth General Court
(2015-2016)

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An Act relative to providing insurance coverage for breast cancer screening.

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.

(a) 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 breast cancer screening technology including but not limited to Magnetic Resonance Imaging (MRI) for high risk women. Said coverage will be provided not less than once annually to women 25 years and older.

(b) A high risk women shall be considered any women who are identified as those who have one or more of the following characteristics:

(1) a personal history with cancer or, two or more first degree relatives with breast cancer;

(2)onset of breast cancer before the age of 50 in one or more first degree relatives;

(3) a history of breast cancer in more than one generation;

(4) cancer in both breasts in one or more first degree relatives

(5) tested positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations

(6) have one or more first degree relatives test positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations

(7) have a personal history with Atypical Lobular Hyperplasia or Atypical Ductal Hyperplasia or Lobular Carcinoma in Situ.

SECTION 2.  Chapter l76A of the General Laws is hereby amended by inserting after section 8Y the following section:-

Section 8Z.

(a) 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 breast cancer screening technology including but not limited to Magnetic Resonance Imaging (MRI) for high risk women. Said coverage will be provided not less than once annually to women 25 years and older.

(b) A high risk women shall be considered any women who are identified as those who have one or more of the following characteristics:

(1) a personal history with cancer or, two or more first degree relatives with breast cancer;

(2)onset of breast cancer before the age of 50 in one or more first degree relatives;

(3) a history of breast cancer in more than one generation;

(4) cancer in both breasts in one or more first degree relatives

(5) tested positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations

(6) have one or more first degree relatives test positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations

(7) have a personal history with Atypical Lobular Hyperplasia or Atypical Ductal Hyperplasia or Lobular Carcinoma in Situ.

SECTION 3.  Chapter 176B of the General Laws is hereby amended by inserting after section 4Y the following section:-

(a) 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 breast cancer screening technology including but not limited to Magnetic Resonance Imaging (MRI) for high risk women. Said coverage will be provided not less than once annually to women 25 years and older. 

(b) A high risk women shall be considered any women who are identified as those who have one or more of the following characteristics:

(1) a personal history with cancer or, two or more first degree relatives with breast cancer;

(2)onset of breast cancer before the age of 50 in one or more first degree relatives;

(3) a history of breast cancer in more than one generation;

(4) cancer in both breasts in one or more first degree relatives

(5) tested positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations

(6) have one or more first degree relatives test positive for Breast Cancer Gene 1 or Breast Cancer Gene 2 mutations

(7) have a personal history with Atypical Lobular Hyperplasia or Atypical Ductal Hyperplasia or Lobular Carcinoma in Situ.

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.