BILL NUMBER: S6551
SPONSOR: BAILEY
 
TITLE OF BILL:
An act to amend the insurance law, in relation to including image-guided
biopsies under certain insurance coverage for breast cancer screening
 
PURPOSE:
This bill would require coverage for image-guided breast biopsies.
Image-guided breast biopsies confirm the presence or absence of malig-
nant tissue and are used to guide treatment if necessary. Patient out-
of-pocket costs for image-guided breast biopsy can run in the thousands
of dollars depending on site-of-service, making cost a barrier to access
and timely diagnosis. Access to cancer screening and treatment should
not be reliant upon a patient's ò ability to pay for these biopsies.
 
SUMMARY OF PROVISIONS:
Section 1 amends section 3216 of the insurance law.
Section 2 amends section 3221 of the insurance law.
Section 3 amends section 4303 of the insurance law.
Section 4 amends section 3216 of the insurance law.
Section 5 amends section 3221 of the insurance law.
Section 6 amends section 4303 of the insurance law.
 
JUSTIFICATION:
Breast cancer is one of the most prevalent and deadly forms of cancer.
Every year, over 16,700 New Yorkers are diagnosed with breast cancer,
and about 2,500 die from the disease. It is estimated that one in eight
women will develop breast cancer during her life.
Breast cancer is also one of the most treatable cancers if caught early.
There has been a more than 40% reduction in mortality from breast cancer
since the United States initiated widespread screening mammography in
the late 1980s. It is essential to find breast cancer early, at its most
curable stages, and be able to act on these findings. Image-guided biop-
sies are crucial in discovering and identifying treatment paths forward.
Breast cancer disproportionately affects people of color, imposing a
heavier burden on communities already facing systemic health dispari-
ties. African American and Hispanic women are more likely to be diag-
nosed with aggressive forms of breast cancer at later stages, leading to
poorer outcomes compared to their white counterparts. Factors such as
limited access to healthcare, lower rates of screening and early
detection, socioeconomic inequalities, and cultural barriers contribute
to this disparity. Moreover, once diagnosed, people of color often face
additional challenges in accessing high-quality treatment and support
services.
Addressing these disparities requires targeted efforts to improve
healthcare access, raise awareness, and provide culturally competent
care to ensure equitable outcomes for all individuals affected by breast
cancer.
By expanding coverage for image-guided breast biopsy, this bill will
ensure that individuals from all backgrounds have access to the lifesav-
ing screenings and procedures they need. This bill will not only save
lives but also reduce health disparities and promote health equity in
our state.
 
LEGISLATIVE HISTORY:
New bill.
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
This act shall take effect on January 1, 2026 and shall apply to all
policies and contracts issued, renewed, modified, altered or amended on
or after such date.

Statutes affected:
S6551: 3216 insurance law, 3216(i) insurance law, 3221 insurance law, 3221(l) insurance law, 4303 insurance law, 4303(p) insurance law