OLR Bill Analysis

sSB 97 (File 17, as amended by Senate "A")*

AN ACT CONCERNING BREAST CANCER SCREENING.

SUMMARY:

This bill removes a requirement that specified health insurance policies cover breast magnetic resonance imaging (MRI) under the same circumstances as breast ultrasound screening (i. e. , when a woman has dense breast tissue or an increased risk of breast cancer). It also removes a requirement that the policies cover MRIs in all circumstances according to guidelines established by the American College of Radiology. It specifies that the policies must cover breast MRI in accordance with American Cancer Society guidelines.

*Senate Amendment “A” removes from the underlying file a provision that prohibited specified health insurance policies from imposing out-of-pocket expenses (e. g. , coinsurance, copayment, or deductible) on breast ultrasound screening. It also changes the effective date from January 1, 2013 to upon passage.

EFFECTIVE DATE: Upon passage

APPLICABILITY

The bill applies to individual and group health insurance policies that cover (1) basic hospital expenses; (2) basic medical-surgical expenses; (3) major medical expenses; and (4) hospital or medical services, including those provided by HMOs. They also apply to individual policies that cover limited benefit health coverage. (Due to the federal Employee Retirement Income Security Act (ERISA), state insurance benefit mandates do not apply to self-insured benefit plans. )

COMMITTEE ACTION

Insurance and Real Estate Committee

Joint Favorable Substitute

Appropriations Committee

Joint Favorable