The bill amends various sections of the General Laws related to health insurance coverage for mammograms and pap smears. It mandates that individual or group hospital or medical expense insurance policies, as well as nonprofit hospital service plans, nonprofit medical service plans, and health maintenance organization plans, provide coverage for mammograms and pap smears in accordance with the American Cancer Society guidelines. The bill specifies that coverage must include two screening mammograms per year when recommended by a physician for women who have been treated for breast cancer within the last five years, are at high risk of developing breast cancer due to genetic predisposition or high-risk lesions on prior biopsies, and any additional screenings deemed medically necessary for proper breast cancer screening in accordance with American College of Radiology guidelines. This includes, but is not limited to, magnetic resonance imaging (MRI), ultrasound, or molecular breast imaging for any person who has been notified of the existence of dense breast tissue.

The bill introduces insertions to the existing law, which include the mandate for coverage of additional screenings and the specific inclusion of MRI, ultrasound, or molecular breast imaging for individuals with dense breast tissue. Deletions from the current law are replaced with these insertions to update the coverage requirements. The bill excludes certain types of insurance coverage from these provisions, such as hospital confinement indemnity, disability income, accident only, long-term care, Medicare supplement, limited benefit health, specified disease indemnity, and other limited benefit policies. The act is set to take effect on January 1, 2024.

Statutes affected:
1134: 27-18-41, 27-19-20, 27-20-17, 27-41-30