Connecticut 2017 Regular Session Status: In Committee

SB 810 — AN ACT REDEFINING MAMMOGRAM AND ELIMINATING COST-SHARING FOR MAMMOGRAMS, BREAST ULTRASOUNDS AND MAGNETIC RESONANCE IMAGING OF BREASTS.

Last action — FAV. CHG. OF REF., SEN. TO COMM. ON Appropriations

  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2017 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

21 added · 21 removed

Plain-language change summary

The bill now redefines "mammogram" to include specific HCPCS codes and eliminates any coinsurance, copayment, deductible, or out-of-pocket expenses for mammograms and breast ultrasounds, except in high deductible health plans. Additionally, the legislation emphasizes the provision of comprehensive ultrasound screenings for women with dense breast tissue or increased breast cancer risk. It also requires that mammography reports inform patients about their breast density and potential additional screening options. These changes aim to enhance access to critical breast health screenings without out-of-pocket costs for patients under most health insurance policies.

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AN ACT CONCERNING COST-SHARING FOR MAMMOGRAMS AND BREAST ULTRASOUNDS.
AN ACT REDEFINING MAMMOGRAM AND ELIMINATING COST-SHARING FOR MAMMOGRAMS, BREAST ULTRASOUNDS AND MAGNETIC RESONANCE IMAGING OF BREASTS.
General Assembly   Raised Bill No.
General Assembly   Substitute Bill No.
810 January Session, 2017   LCO No.
810 January Session, 2017   *_____SB00810INSAPP030817____* AN ACT REDEFINING MAMMOGRAM AND ELIMINATING COST-SHARING FOR MAMMOGRAMS, BREAST ULTRASOUNDS AND MAGNETIC RESONANCE IMAGING OF BREASTS.
3871   *03871_______INS* Referred to Committee on INSURANCE AND REAL ESTATE   Introduced by:
  (INS)   AN ACT CONCERNING COST-SHARING FOR MAMMOGRAMS AND BREAST ULTRASOUNDS.
(a) (1) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide benefits for mammographic examinations to any woman covered under the policy that are at least equal to the following minimum requirements:
(a) For purposes of this section:
(1) "Healthcare Common Procedure Coding System" or "HCPCS" means the billing codes used by Medicare and overseen by the federal Centers for Medicare and Medicaid Services that are based on the current procedural technology codes developed by the American Medical Association;
and (2) "Mammogram" means mammographic examination or breast tomosynthesis, including, but not limited to, a procedure with a HCPCS code of 77051, 77052, 77055, 77056, 77057, 77063, G0202, G0204, G0206 or G0279, or any subsequent corresponding code.
[(a)] (b) (1) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (10), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide benefits for [mammographic examinations] mammograms to any woman covered under the policy that are at least equal to the following minimum requirements:
(A) Comprehensive ultrasound [screening] examinations of an entire breast or breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast Imaging Reporting and Data System established by the American College of Radiology or if a woman is believed to be at increased risk for breast cancer due to family history or prior personal history of breast cancer, positive genetic testing or other indications as determined by a woman's physician or advanced practice registered nurse;
(A) Comprehensive ultrasound screening of an entire breast or breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast Imaging Reporting and Data System established by the American College of Radiology or if a woman is believed to be at increased risk for breast cancer due to family history or prior personal history of breast cancer, positive genetic testing or other indications as determined by a woman's physician or advanced practice registered nurse;
[(b) Benefits under this section shall be subject to any policy provisions that apply to other services covered by such policy, except that no such policy shall impose a copayment that exceeds a maximum of twenty dollars for an ultrasound screening under subparagraph (A) of subdivision (2) of subsection (a) of this section.] (b) No such policy shall impose a copayment or deductible for an in-network mammogram or comprehensive ultrasound examination under subsection (a) of this section.
[(b)] (c) Benefits under this section shall be subject to any policy provisions that apply to other services covered by such policy, except that no such policy shall impose [a copayment that exceeds a maximum of twenty dollars for an ultrasound screening under subparagraph (A) of subdivision (2) of subsection (a) of this section.] any coinsurance, copayment, deductible or other out-of-pocket expense for such benefits, except a high deductible health plan, as that term is used in subsection (f) of section 38a-493, shall not be subject to the deductible limits set forth in this subsection.
(c) Each mammography report provided to a patient shall include information about breast density, based on the Breast Imaging Reporting and Data System established by the American College of Radiology.
[(c)] (d) Each mammography report provided to a patient shall include information about breast density, based on the Breast Imaging Reporting and Data System established by the American College of Radiology.
"If your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary screening tests, which can include a breast ultrasound [screening] examination or a breast MRI examination, or both, depending on your individual risk factors.
"If your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary screening tests, which can include a breast ultrasound screening or a breast MRI examination, or both, depending on your individual risk factors.
(a) (1) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide benefits for mammographic examinations to any woman covered under the policy that are at least equal to the following minimum requirements:
(a) For purposes of this section:
(1) "Healthcare Common Procedure Coding System" or "HCPCS" means the billing codes used by Medicare and overseen by the federal Centers for Medicare and Medicaid Services that are based on the current procedural technology codes developed by the American Medical Association;
and (2) "Mammogram" means mammographic examination or breast tomosynthesis, including, but not limited to, a procedure with a HCPCS code of 77051, 77052, 77055, 77056, 77057, 77063, G0202, G0204, G0206 or G0279, or any subsequent corresponding code.
[(a)] (b) (1) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, renewed, amended or continued in this state shall provide benefits for [mammographic examinations] mammograms to any woman covered under the policy that are at least equal to the following minimum requirements:
(A) Comprehensive ultrasound [screening] examinations of an entire breast or breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast Imaging Reporting and Data System established by the American College of Radiology or if a woman is believed to be at increased risk for breast cancer due to family history or prior personal history of breast cancer, positive genetic testing or other indications as determined by a woman's physician or advanced practice registered nurse;
(A) Comprehensive ultrasound screening of an entire breast or breasts if a mammogram demonstrates heterogeneous or dense breast tissue based on the Breast Imaging Reporting and Data System established by the American College of Radiology or if a woman is believed to be at increased risk for breast cancer due to family history or prior personal history of breast cancer, positive genetic testing or other indications as determined by a woman's physician or advanced practice registered nurse;
[(b) Benefits under this section shall be subject to any policy provisions that apply to other services covered by such policy, except that no such policy shall impose a copayment that exceeds a maximum of twenty dollars for an ultrasound screening under subparagraph (A) of subdivision (2) of subsection (a) of this section.] (b) No such policy shall impose a copayment or deductible for an in-network mammogram or a comprehensive ultrasound examination under subsection (a) of this section.
[(b)] (c) Benefits under this section shall be subject to any policy provisions that apply to other services covered by such policy, except that no such policy shall impose [a copayment that exceeds a maximum of twenty dollars for an ultrasound screening under subparagraph (A) of subdivision (2) of subsection (a) of this section.] any coinsurance, copayment, deductible or other out-of-pocket expense for such benefits, except a high deductible health plan, as that term is used in subsection (f) of section 38a-493, shall not be subject to the deductible limits set forth in this subsection.
(c) Each mammography report provided to a patient shall include information about breast density, based on the Breast Imaging Reporting and Data System established by the American College of Radiology.
[(c)] (d) Each mammography report provided to a patient shall include information about breast density, based on the Breast Imaging Reporting and Data System established by the American College of Radiology.
"If your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary screening tests, which can include a breast ultrasound [screening] examination or a breast MRI examination, or both, depending on your individual risk factors.
"If your mammogram demonstrates that you have dense breast tissue, which could hide small abnormalities, you might benefit from supplementary screening tests, which can include a breast ultrasound screening or a breast MRI examination, or both, depending on your individual risk factors.
2 January 1, 2018 38a-530 Statement of Purpose:
2 January 1, 2018 38a-530 INS Joint Favorable Subst.
To prohibit certain health insurance policies from imposing a copayment or deductible on mammograms and breast ultrasounds.
C/R APP
[Proposed deletions are enclosed in brackets.
Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]
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Action History

  1. FAV. CHG. OF REF., SEN. TO COMM. ON Appropriations

  2. FAV. CHG. OF REF. HOUSE TO COMM.ON APP

  3. RPTD. OUT OF LCO

  4. FILED WITH LCO

  5. Joint Favorable Substitute Change of Reference APP

  6. PUBLIC HEARING 0223

  7. REF. TO JOINT COMM. ON Insurance and Real Estate

Sponsors

  • John K.' b'Hampton · Primary
  • Kevin C.' b'Kelly · Primary

Sponsorship breakdown

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2 sponsors · 0 co-sponsors · 185 not signed on

Sponsors (2)

  • b'Hampton, John K.'
  • b'Kelly, Kevin C.'

Co-sponsors (0)

None.

Not signed on (185)

185 members have not signed on to this bill.

Show all 185 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

Who sponsors SB 810?
SB 810 is sponsored by b'Hampton, John K.' and b'Kelly, Kevin C.'.
What is the current status of SB 810?
This bill died with 2017 Regular Session. It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 810?
Track SB 810 free on One Click Politics — get push/email alerts when it moves.

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