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ARIZONA HOUSE OF REPRESENTATIVESFifty-sixth Legislature First Regular Session |
Senate: HHS DPA 7-0-0-0 | 3rd Read 25-3-2-0
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SB 1601: breast examinations; cancer screenings; age
Sponsor: Senator Shamp, LD 29
Transmitted to the Governor
Overview
Directs corporations, health care services organizations, disability insurers, group and blanket disability insurers (health care insurers) to provide coverage for a mammogram and digital breast tomosynthesis, magnetic resonance imaging (MRI) or ultrasound at the age and intervals as recommended by the National Comprehensive Cancer Network (NCCN).
History
A health care insurer includes a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation and medical service corporation, prepaid dental plan organization, dental service corporation or optometric service corporation (A.R.S. § 20-3101).
Health care insurer contracts that provide coverage for surgical services for a mastectomy must also provide coverage for mammography screening performed on dedicated equipment for diagnostic purposes on referral by a patient's physician, subject to all policy terms, conditions and guidelines. A health care insurer must provide coverage for a: 1) baseline mammogram for a woman from age 35 to 39; 2) mammogram for a woman from age 40 to 49 every two years or more frequently based on the recommendation of the woman's physician; and 3) mammogram every year for a woman 50 years of age and over (A.R.S. §§ 20-826, 20-1057, 20-1342, 20-1402 and 20-1404).
A diagnostic mammography is an x-ray imaging of the breast performed on individuals who have symptoms or physical signs indicative of breast disease. A screening mammography is an -x-ray imaging of the breast of asymptomatic persons (A.R.S. § 30-651).
The NCCN is a not-for-profit alliance of 32 leading cancer centers devoted to patient care, research and education. This organization is dedicated to improving and facilitating quality, effective, equitable and accessible cancer care so all patients can live better lives. NCCN programs offer access to expert physicians, superior treatment, quality and safety initiatives that continuously improve the effectiveness and efficiency of cancer care globally (NCCN).
Provisions
1.
Requires health care insurer contracts
that provide mastectomy surgical services coverage to also provide coverage for
preventive mammography screening and diagnostic imaging on referral by a
patient's physician, subject to the policy's terms, conditions and guidelines,
including a mammogram and digital breast tomosynthesis, MRI, ultrasound or
other modality and at such age and intervals as recommended by the NCCN. (Sec.
1-5)
2. States that the preventive mammography screening and diagnostic image coverage includes patients at risk for breast cancer who have a:
a) family history with one or more first or second-degree relatives with breast cancer;
b) prior diagnosis of breast cancer; or
c) positive test for hereditary gene mutations or heterogeneously or dense breast tissue based on the Breast Imaging Reporting and Data System of the American College of Radiology. (Sec. 1-5)
3. Adds digital breast tomosynthesis to the definition of screening mammography. (Sec. 6)
4. Defines the term digital breast tomosynthesis. (Sec. 6)
5. Makes technical and conforming changes. (Sec. 1- 6)
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SB 1601
Initials AG Page 0 Transmitted
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