1Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
2act relating to insurance; amending, revising, and
3consolidating the law providing for the incorporation of
4insurance companies, and the regulation, supervision, and
5protection of home and foreign insurance companies, Lloyds
6associations, reciprocal and inter-insurance exchanges, and
7fire insurance rating bureaus, and the regulation and
8supervision of insurance carried by such companies,
9associations, and exchanges, including insurance carried by
10the State Workmen's Insurance Fund; providing penalties; and
11repealing existing laws," further providing for coverage for
12mammographic examinations.

13The General Assembly of the Commonwealth of Pennsylvania
14hereby enacts as follows:

15Section 1. Section 632 of the act of May 17, 1921 (P.L.682,
16No.284), known as The Insurance Company Law of 1921, amended
17December 15, 1992, (P.L.1129, No.148), is amended to read:

18Section 632. Coverage for Mammographic Examinations.--(a)
19All group or individual health or sickness or accident insurance 
20policies providing hospital or medical/surgical coverage and all 
21group or individual subscriber contracts or certificates issued
 

1by any entity subject to 40 Pa.C.S. Ch. 61 (relating to hospital 
2plan corporations) or 63 (relating to professional health 
3services plan corporations), this act, the act of December 29, 
41972 (P.L.1701, No.364), known as the "Health Maintenance 
5Organization Act," [the act of July 29, 1977 (P.L.105, No.38), 
6known as the "Fraternal Benefit Society Code,"] or an employe 
7welfare benefit plan as defined in section 3 of the Employee 
8Retirement Income Security Act of 1974 (Public Law 93-406, 29 
9U.S.C. § 1001 et seq.) providing hospital or medical/surgical 
10coverage shall also provide coverage for mammographic 
11examinations. The minimum coverage required shall include all 
12costs associated with a mammogram every year for women 40 years 
13of age or older and with any mammogram based on a physician's 
14recommendation for women under 40 years of age, including 
15ultrasound screening, magnetic resonance imaging or other 
16supplemental screening if a mammogram demonstrates heterogeneous 
17or dense breast tissue based on the Breast Imaging Reporting and 
18Data system established by the American College of Radiology or 
19if a woman is believed to be at increased risk for breast cancer 
20due to family history or prior personal history of breast 
21cancer, positive genetic testing or other indications as deemed 
22medically necessary by a physician. Prior to payment for a 
23screening mammogram, insurers shall verify that the screening 
24mammography service provider is properly licensed by the 
25department in accordance with the act of July 9, 1992 (P.L.449, 
26No.93), known as the "Mammography Quality Assurance Act." 
27Nothing in this section shall be construed to require an insurer 
28to cover the surgical procedure known as mastectomy or to 
29prevent application of deductible or copayment provisions 
30contained in the policy or plan.

1(b) This section shall not apply to the following types of 
2policies:

3(1) Accident only.

4(2) Limited benefit.

5(3) Credit.

6(4) Dental.

7(5) Vision.

8(6) Specified disease.

9(7) Medicare supplement.

10(8) Civilian Health and Medical Program of the Uniformed
11Services (CHAMPUS) supplement.

12(9) Long-term care or disability income.

13(10) Workers' compensation.

14(11) Automobile medical payment.

15Section 2. This act shall take effect in 60 days.