THE GENERAL ASSEMBLY OF PENNSYLVANIA

SENATE BILL

INTRODUCED BY M. WHITE, PILEGGI, TARTAGLIONE, FONTANA, KITCHEN, ERICKSON, ALLOWAY, WILLIAMS, TOMLINSON, ROBBINS, RAFFERTY, COSTA, WOZNIAK, BROWNE, STOUT, YAW, KASUNIC, WAUGH, BRUBAKER, O'PAKE, BOSCOLA AND FERLO, APRIL 1, 2009

REFERRED TO BANKING AND INSURANCE, APRIL 1, 2009  

AN ACT

Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An

act relating to insurance; amending, revising, and

consolidating the law providing for the incorporation of

insurance companies, and the regulation, supervision, and

protection of home and foreign insurance companies, Lloyds

associations, reciprocal and inter-insurance exchanges, and

fire insurance rating bureaus, and the regulation and

supervision of insurance carried by such companies,

associations, and exchanges, including insurance carried by

the State Workmen's Insurance Fund; providing penalties; and

repealing existing laws," in health and accident insurance,

further providing for coverage for mammographic examinations

and ultrasound screenings of the breast.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Section 632 of the act of May 17, 1921 (P.L.682,

No.284), known as The Insurance Company Law of 1921, amended

December 15, 1992 (P.L.1129, No.148), is amended to read:

Section 632.  Coverage for Mammographic Examinations and

Ultrasound Screenings of Breast.--(a)  All group or individual

health [or], sickness or accident insurance policies providing

hospital or medical/surgical coverage and all group or

individual subscriber contracts or certificates issued by any

entity subject to 40 Pa.C.S. Ch. 61 (relating to hospital plan

corporations) or 63 (relating to professional health services

plan corporations), this act, the act of December 29, 1972

(P.L.1701, No.364), known as the "Health Maintenance

Organization Act," [the act of July 29, 1977 (P.L.105, No.38),

known as the "Fraternal Benefit Society Code,"] or an employe

welfare benefit plan as defined in section 3 of the Employee

Retirement Income Security Act of 1974 (Public Law 93-406, 29

U.S.C. § 1001 et seq.) providing hospital or medical/surgical

coverage shall also provide coverage for mammographic

examinations and ultrasound screenings of the breast.

(b)  The minimum coverage required shall include all costs

associated with a mammogram or ultrasound screening of the

breast every year for women 40 years of age or older and with

any mammogram and ultrasound screening of the breast based on a

physician's recommendation for women [under 40 years] of any 

age.

(c)  Prior to payment for a screening mammogram and

ultrasound screening of the breast, insurers shall verify that

the screening mammography and ultrasound screening service

provider is properly licensed by the department in accordance

with the act of July 9, 1992 (P.L.449, No.93), known as the

"Mammography Quality Assurance Act."

(d)  Nothing in this section shall be construed to require an

insurer to cover the surgical procedure known as mastectomy or

to prevent application of deductible or copayment provisions

contained in the policy or plan.

Section 2.  This act shall take effect in 60 days.