Bill > S04072

This bill requires insurance providers in New York to expand coverage for breast cancer screening procedures, specifically mandating that group or blanket insurance policies provide coverage for sonograms and other diagnostic procedures used to detect breast cancer. The bill applies to individuals with a prior history of breast cancer or those who have a first-degree relative with a prior history of breast cancer. For large group policies, insurers must now cover annual mammograms for all persons aged 35-39, as well as those with a personal or family history of breast cancer. The bill also allows for various screening and diagnostic imaging methods recommended by physicians, including mammograms, breast ultrasounds, and magnetic resonance imaging (MRI), based on nationally recognized clinical practice guidelines. These guidelines are defined as evidence-based recommendations developed by independent organizations or medical professional societies using a transparent methodology. The expanded coverage aims to improve early detection of breast cancer by ensuring more comprehensive screening options are available to at-risk individuals, with the final determination of medical necessity still resting with the insurance provider.

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https://www.nysenate.gov/legislation/bills/2025/S4072