HB 25

1	A bill to be entitled
2	An act relating to mammogram reports; amending ss.
3	627.6418, 627.6613, and 641.31095, F.S.; requiring that
4	all mammography reports include information and a notice
5	about breast density; providing an effective date.
6
7	Be It Enacted by the Legislature of the State of Florida:
8
9	Section 1.  Section 627.6418, Florida Statutes, is amended
10	to read:
11	627.6418  Coverage for mammograms.-
12	(1)  An accident or health insurance policy issued,
13	amended, delivered, or renewed in this state must provide
14	coverage for at least the following:
15	(a)  A baseline mammogram for any woman who is 35 years of
16	age or older, but younger than 40 years of age.
17	(b)  A mammogram every 2 years for any woman who is 40
18	years of age or older, but younger than 50 years of age, or more
19	frequently based on the patient's physician's recommendation.
20	(c)  A mammogram every year for any woman who is 50 years
21	of age or older.
22	(d)  One or more mammograms a year, based upon a
23	physician's recommendation, for any woman who is at risk for
24	breast cancer because of a personal or family history of breast
25	cancer, because of having a history of biopsy-proven benign
26	breast disease, because of having a mother, sister, or daughter
27	who has or has had breast cancer, or because a woman has not
28	given birth before the age of 30.
29	(2)  Each mammography report provided to a patient shall
30	include information about breast density based on the Breast
31	Imaging Reporting and Data System established by the American
32	College of Radiology. Where applicable, such report shall
33	include the following notice: "If your mammogram demonstrates
34	that you have dense breast tissue, which could hide small
35	abnormalities, you might benefit from supplementary screening
36	tests, including a breast ultrasound screening or a breast MRI
37	examination, or both, depending on your individual risk factors.
38	A report of your mammography results, which contains information
39	about your breast density, has been sent to your physician's
40	office and you should contact your physician if you have any
41	questions or concerns about this report."
42	(3)(2)  Except as provided in paragraph (1)(b), for
43	mammograms done more frequently than every 2 years for women 40
44	years of age or older but younger than 50 years of age, the
45	coverage required by subsection (1) applies, with or without a
46	physician prescription, if the insured obtains a mammogram in an
47	office, facility, or health testing service that uses
48	radiological equipment registered with the Department of Health
49	for breast cancer screening. The coverage is subject to the
50	deductible and coinsurance provisions applicable to outpatient
51	visits, and is also subject to all other terms and conditions
52	applicable to other benefits. This section does not affect any
53	requirements or prohibitions relating to who may perform,
54	analyze, or interpret a mammogram or the persons to whom the
55	results of a mammogram may be furnished or released.
56	(4)(3)  This section does not apply to disability income,
57	specified disease, or hospital indemnity policies.
58	(5)(4)  Every insurer subject to the requirements of this
59	section shall make available to the policyholder as part of the
60	application, for an appropriate additional premium, the coverage
61	required in this section without such coverage being subject to
62	the deductible or coinsurance provisions of the policy.
63	Section 2.  Section 627.6613, Florida Statutes, is amended
64	to read:
65	627.6613  Coverage for mammograms.-
66	(1)  A group, blanket, or franchise accident or health
67	insurance policy issued, amended, delivered, or renewed in this
68	state must provide coverage for at least the following:
69	(a)  A baseline mammogram for any woman who is 35 years of
70	age or older, but younger than 40 years of age.
71	(b)  A mammogram every 2 years for any woman who is 40
72	years of age or older, but younger than 50 years of age, or more
73	frequently based on the patient's physician's recommendation.
74	(c)  A mammogram every year for any woman who is 50 years
75	of age or older.
76	(d)  One or more mammograms a year, based upon a
77	physician's recommendation, for any woman who is at risk for
78	breast cancer because of a personal or family history of breast
79	cancer, because of having a history of biopsy-proven benign
80	breast disease, because of having a mother, sister, or daughter
81	who has or has had breast cancer, or because a woman has not
82	given birth before the age of 30.
83	(2)  Each mammography report provided to a patient shall
84	include information about breast density based on the Breast
85	Imaging Reporting and Data System established by the American
86	College of Radiology. Where applicable, such report shall
87	include the following notice: "If your mammogram demonstrates
88	that you have dense breast tissue, which could hide small
89	abnormalities, you might benefit from supplementary screening
90	tests, including a breast ultrasound screening or a breast MRI
91	examination, or both, depending on your individual risk factors.
92	A report of your mammography results, which contains information
93	about your breast density, has been sent to your physician's
94	office and you should contact your physician if you have any
95	questions or concerns about this report."
96	(3)(2)  Except as provided in paragraph (1)(b), for
97	mammograms done more frequently than every 2 years for women 40
98	years of age or older but younger than 50 years of age, the
99	coverage required by subsection (1) applies, with or without a
100	physician prescription, if the insured obtains a mammogram in an
101	office, facility, or health testing service that uses
102	radiological equipment registered with the Department of Health
103	for breast cancer screening. The coverage is subject to the
104	deductible and coinsurance provisions applicable to outpatient
105	visits, and is also subject to all other terms and conditions
106	applicable to other benefits. This section does not affect any
107	requirements or prohibitions relating to who may perform,
108	analyze, or interpret a mammogram or the persons to whom the
109	results of a mammogram may be furnished or released.
110	(4)(3)  Every insurer referred to in subsection (1) shall
111	make available to the policyholder as part of the application,
112	for an appropriate additional premium, the coverage required in
113	this section without such coverage being subject to the
114	deductible or coinsurance provisions of the policy.
115	Section 3.  Section 641.31095, Florida Statutes, is amended
116	to read:
117	641.31095  Coverage for mammograms.-
118	(1)  Every health maintenance contract issued or renewed on
119	or after January 1, 1996, shall provide coverage for at least
120	the following:
121	(a)  A baseline mammogram for any woman who is 35 years of
122	age or older, but younger than 40 years of age.
123	(b)  A mammogram every 2 years for any woman who is 40
124	years of age or older, but younger than 50 years of age, or more
125	frequently based on the patient's physician's recommendations.
126	(c)  A mammogram every year for any woman who is 50 years
127	of age or older.
128	(d)  One or more mammograms a year, based upon a
129	physician's recommendation for any woman who is at risk for
130	breast cancer because of a personal or family history of breast
131	cancer, because of having a history of biopsy-proven benign
132	breast disease, because of having a mother, sister, or daughter
133	who has had breast cancer, or because a woman has not given
134	birth before the age of 30.
135	(2)  Each mammography report provided to a patient shall
136	include information about breast density based on the Breast
137	Imaging Reporting and Data System established by the American
138	College of Radiology. Where applicable, such report shall
139	include the following notice: "If your mammogram demonstrates
140	that you have dense breast tissue, which could hide small
141	abnormalities, you might benefit from supplementary screening
142	tests, including a breast ultrasound screening or a breast MRI
143	examination, or both, depending on your individual risk factors.
144	A report of your mammography results, which contains information
145	about your breast density, has been sent to your physician's
146	office and you should contact your physician if you have any
147	questions or concerns about this report."
148	(3)(2)  The coverage required by this section is subject to
149	the deductible and copayment provisions applicable to outpatient
150	visits, and is also subject to all other terms and conditions
151	applicable to other benefits. A health maintenance organization
152	shall make available to the subscriber as part of the
153	application, for an appropriate additional premium, the coverage
154	required in this section without such coverage being subject to
155	any deductible or copayment provisions in the contract.
156	Section 4.  This act shall take effect October 1, 2011.

CODING: Words stricken are deletions; words underlined are additions.