Florida Senate - 2016                                     SB 266
       
       
        
       By Senator Ring
       
       
       
       
       
       29-00357-16                                            2016266__
    1                        A bill to be entitled                      
    2         An act relating to mammography reports; amending ss.
    3         627.6418, 627.6613, and 641.31095, F.S.; requiring
    4         that mammography reports include a specified notice
    5         regarding breast density; making technical changes;
    6         providing an effective date.
    7          
    8  Be It Enacted by the Legislature of the State of Florida:
    9  
   10         Section 1. Section 627.6418, Florida Statutes, is amended
   11  to read:
   12         627.6418 Coverage for mammograms.—
   13         (1) An accident or health insurance policy issued, amended,
   14  delivered, or renewed in this state must provide coverage for at
   15  least the following:
   16         (a) A baseline mammogram for any woman who is 35 years of
   17  age or older, but younger than 40 years of age.
   18         (b) A mammogram every 2 years for any woman who is 40 years
   19  of age or older, but younger than 50 years of age, or more
   20  frequently based on the recommendation of the patient’s
   21  physician physician’s recommendation.
   22         (c) A mammogram every year for any woman who is 50 years of
   23  age or older.
   24         (d) One or more mammograms a year, based upon a physician’s
   25  recommendation, for any woman who is at risk for breast cancer
   26  because of a personal or family history of breast cancer,
   27  because of having a history of biopsy-proven benign breast
   28  disease, because of having a mother, sister, or daughter who has
   29  or has had breast cancer, or because a woman has not given birth
   30  before the age of 30.
   31         (2) Each mammography report provided to a patient must
   32  include information about breast density based on the Breast
   33  Imaging Reporting and Data System established by the American
   34  College of Radiology and must include the following notice:
   35  Dense breast tissue may hide small abnormalities. If your
   36  mammogram indicates that you have dense breast tissue, you may
   37  benefit from supplementary screening tests, including a breast
   38  ultrasound screening, a breast MRI examination, or both,
   39  depending on your individual risk factors. A report of your
   40  mammography results, including information about your breast
   41  density, has been sent to your physician’s office. If you have
   42  any questions or concerns about this report, you should contact
   43  your physician.”
   44         (3)(2) Except as provided in paragraph (1)(b), for
   45  mammograms done more frequently than every 2 years for women 40
   46  years of age or older but younger than 50 years of age, the
   47  coverage required by subsection (1) applies, with or without a
   48  physician prescription, if the insured obtains a mammogram in an
   49  office, facility, or health testing service that uses
   50  radiological equipment registered with the Department of Health
   51  for breast cancer screening. The coverage is subject to the
   52  deductible and coinsurance provisions applicable to outpatient
   53  visits, and is also subject to all other terms and conditions
   54  applicable to other benefits. This section does not affect any
   55  requirements or prohibitions relating to who may perform,
   56  analyze, or interpret a mammogram or the persons to whom the
   57  results of a mammogram may be furnished or released.
   58         (4)(3) This section does not apply to disability income,
   59  specified disease, or hospital indemnity policies.
   60         (5)(4) Every insurer subject to the requirements of this
   61  section shall make available to the policyholder as part of the
   62  application, for an appropriate additional premium, the coverage
   63  required in this section without such coverage being subject to
   64  the deductible or coinsurance provisions of the policy.
   65         Section 2. Section 627.6613, Florida Statutes, is amended
   66  to read:
   67         627.6613 Coverage for mammograms.—
   68         (1) A group, blanket, or franchise accident or health
   69  insurance policy issued, amended, delivered, or renewed in this
   70  state must provide coverage for at least the following:
   71         (a) A baseline mammogram for any woman who is 35 years of
   72  age or older, but younger than 40 years of age.
   73         (b) A mammogram every 2 years for any woman who is 40 years
   74  of age or older, but younger than 50 years of age, or more
   75  frequently based on the recommendation of the patient’s
   76  physician physician’s recommendation.
   77         (c) A mammogram every year for any woman who is 50 years of
   78  age or older.
   79         (d) One or more mammograms a year, based upon a physician’s
   80  recommendation, for any woman who is at risk for breast cancer
   81  because of a personal or family history of breast cancer,
   82  because of having a history of biopsy-proven benign breast
   83  disease, because of having a mother, sister, or daughter who has
   84  or has had breast cancer, or because a woman has not given birth
   85  before the age of 30.
   86         (2) Each mammography report provided to a patient must
   87  include information about breast density based on the Breast
   88  Imaging Reporting and Data System established by the American
   89  College of Radiology and must include the following notice:
   90  Dense breast tissue may hide small abnormalities. If your
   91  mammogram indicates that you have dense breast tissue, you may
   92  benefit from supplementary screening tests, including a breast
   93  ultrasound screening, a breast MRI examination, or both,
   94  depending on your individual risk factors. A report of your
   95  mammography results, including information about your breast
   96  density, has been sent to your physician’s office. If you have
   97  any questions or concerns about this report, you should contact
   98  your physician.”
   99         (3)(2) Except as provided in paragraph (1)(b), for
  100  mammograms done more frequently than every 2 years for women 40
  101  years of age or older but younger than 50 years of age, the
  102  coverage required by subsection (1) applies, with or without a
  103  physician prescription, if the insured obtains a mammogram in an
  104  office, facility, or health testing service that uses
  105  radiological equipment registered with the Department of Health
  106  for breast cancer screening. The coverage is subject to the
  107  deductible and coinsurance provisions applicable to outpatient
  108  visits, and is also subject to all other terms and conditions
  109  applicable to other benefits. This section does not affect any
  110  requirements or prohibitions relating to who may perform,
  111  analyze, or interpret a mammogram or the persons to whom the
  112  results of a mammogram may be furnished or released.
  113         (4)(3) Every insurer referred to in subsection (1) shall
  114  make available to the policyholder as part of the application,
  115  for an appropriate additional premium, the coverage required in
  116  this section without such coverage being subject to the
  117  deductible or coinsurance provisions of the policy.
  118         Section 3. Section 641.31095, Florida Statutes, is amended
  119  to read:
  120         641.31095 Coverage for mammograms.—
  121         (1) Every health maintenance contract issued or renewed on
  122  or after January 1, 1996, shall provide coverage for at least
  123  the following:
  124         (a) A baseline mammogram for any woman who is 35 years of
  125  age or older, but younger than 40 years of age.
  126         (b) A mammogram every 2 years for any woman who is 40 years
  127  of age or older, but younger than 50 years of age, or more
  128  frequently based on the recommendation of the patient’s
  129  physician physician’s recommendations.
  130         (c) A mammogram every year for any woman who is 50 years of
  131  age or older.
  132         (d) One or more mammograms a year, based upon a physician’s
  133  recommendation for any woman who is at risk for breast cancer
  134  because of a personal or family history of breast cancer,
  135  because of having a history of biopsy-proven benign breast
  136  disease, because of having a mother, sister, or daughter who has
  137  had breast cancer, or because a woman has not given birth before
  138  the age of 30.
  139         (2) Each mammography report provided to a patient must
  140  include information about breast density based on the Breast
  141  Imaging Reporting and Data System established by the American
  142  College of Radiology and must include the following notice:
  143  Dense breast tissue may hide small abnormalities. If your
  144  mammogram indicates that you have dense breast tissue, you may
  145  benefit from supplementary screening tests, including a breast
  146  ultrasound screening, a breast MRI examination, or both,
  147  depending on your individual risk factors. A report of your
  148  mammography results, including information about your breast
  149  density, has been sent to your physician’s office. If you have
  150  any questions or concerns about this report, you should contact
  151  your physician.”
  152         (3)(2) The coverage required by this section is subject to
  153  the deductible and copayment provisions applicable to outpatient
  154  visits, and is also subject to all other terms and conditions
  155  applicable to other benefits. A health maintenance organization
  156  shall make available to the subscriber as part of the
  157  application, for an appropriate additional premium, the coverage
  158  required in this section without such coverage being subject to
  159  any deductible or copayment provisions in the contract.
  160         Section 4. This act shall take effect October 1, 2016.