S0595B1396A05961 AJM:EJH 05/27/20 #90 A05961
AMENDMENTS TO SENATE BILL NO. 595
Sponsor: REPRESENTATIVE PICKETT
Printer's No. 1396
Amend Bill, page 2, line 16, by inserting a period after
"age"
Amend Bill, page 2, lines 17 through 30; page 3, lines 1
through 17; by striking out all of said lines on said pages
Amend Bill, page 3, by inserting between lines 26 and 27
(b) A group or individual health or sickness or accident
insurance policy providing hospital or medical/surgical coverage
and a group or individual subscriber contract or certificate
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. ยง 1001 et seq.) providing hospital or
medical/surgical coverage shall also provide coverage for breast
imaging. The minimum coverage required shall include
supplemental magnetic resonance imaging or, if such imaging is
not possible, ultrasound if recommended by the treating
physician because the woman is believed to be at an increased
risk of breast cancer due to:
(1) personal history of atypical breast histologies;
(2) personal history or family history of breast cancer;
(3) genetic predisposition for breast cancer;
(4) prior therapeutic thoracic radiation therapy;
(5) heterogeneously dense breast tissue based on breast
composition categories of the Breast Imaging and Reporting Data
System established by the American College of Radiology with any
one of the following risk factors:
(i) lifetime risk of breast cancer of greater than 20%,
according to risk assessment tools based on family history;
(ii) personal history of BRCA1 or BRCA2 gene mutations;
(iii) first-degree relative with a BRCA1 or BRCA2 gene
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mutation but not having had genetic testing herself;
(iv) prior therapeutic thoracic radiation therapy between 10
and 30 years of age; or
(v) personal history of Li-Fraumeni syndrome, Cowden
syndrome or Bannayan-Riley-Ruvalcaba syndrome or a first-degree
relative with one of these syndromes.
(6) extremely dense breast tissue based on breast
composition categories of the Breast Imaging and Reporting Data
System established by the American College of Radiology. Nothing
in this subsection shall be construed to require an insurer to
cover the surgical procedure known as mastectomy or to prevent
the application of deductible, copayment or coinsurance
provisions contained in the policy or plan.
Amend Bill, page 3, line 27, by striking out "(b)" and
inserting
(c)
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