Connecticut Seal

General Assembly

 

Substitute Bill No. 10

    January Session, 2011

 

*_____SB00010INS___022511____*

AN ACT CONCERNING INSURANCE COVERAGE FOR BREAST MAGNETIC RESONANCE IMAGING.

Be it enacted by the Senate and House of Representatives in General Assembly convened:

Section 1. Subsection (a) of section 38a-503 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2012):

(a) [Each] On and after January 1, 2012, and until December 31, 2013, each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), [(6),] (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state [on or after October 1, 2001,] shall provide: [benefits]

(1) Benefits for mammographic examinations to any woman covered under the policy which are at least equal to the following minimum requirements: [(1)] (A) A baseline mammogram for any woman who is thirty-five to thirty-nine years of age, inclusive; and [(2)] (B) a mammogram every year for any woman who is forty years of age or older; [.] and

(2) [Such policy shall provide additional] Additional benefits for comprehensive ultrasound screening and magnetic resonance imaging, 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] in accordance with guidelines established by the National Comprehensive Cancer Network, the American Cancer Society or the American Society of Clinical Oncology.

Sec. 2. Subsection (a) of section 38a-530 of the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2012):

(a) [Each] On and after January 1, 2012, and until December 31, 2013, each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state [on or after October 1, 2001,] shall provide: [benefits]

(1) Benefits for mammographic examinations to any woman covered under the policy which are at least equal to the following minimum requirements: [(1)] (A) A baseline mammogram for any woman who is thirty-five to thirty-nine years of age, inclusive; and [(2)] (B) a mammogram every year for any woman who is forty years of age or older; [.] and

(2) [Such policy shall provide additional] Additional benefits for comprehensive ultrasound screening and magnetic resonance imaging, 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] in accordance with guidelines established by the National Comprehensive Cancer Network, the American Cancer Society or the American Society of Clinical Oncology.

This act shall take effect as follows and shall amend the following sections:

Section 1

January 1, 2012

38a-503(a)

Sec. 2

January 1, 2012

38a-530(a)

INS

Joint Favorable Subst.