Chapter 331
2023 -- H 5283 SUBSTITUTE A
Enacted 06/24/2023

A N   A C T
RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES -- MAMMOGRAMS AND PAP SMEARS -- COVERAGE MANDATED

Introduced By: Representatives Fogarty, Kazarian, Carson, Tanzi, Lima, Cotter, Spears, Donovan, Henries, and McGaw

Date Introduced: February 01, 2023

It is enacted by the General Assembly as follows:
     SECTION 1. Section 27-18-41 of the General Laws in Chapter 27-18 entitled "Accident
and Sickness Insurance Policies" is hereby amended to read as follows:
     27-18-41. Mammograms and pap smears — Coverage mandated.
     (a)(1) Every individual or group hospital or medical expense insurance policy or individual
or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this
state shall provide coverage for mammograms and pap smears, in accordance with guidelines
established by the American Cancer Society.
     (2) Notwithstanding the provisions of this chapter, every individual or group hospital or
medical insurance policy or individual or group hospital or medical services plan contract
delivered, issued for delivery, or renewed in this state shall pay for:
     (Ai) Two two (2) screening mammograms per year when recommended by a physician for
women who have been treated for breast cancer within the last five (5) years or are at high risk of
developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple first-
degree relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical ductal
hyperplasia.; and
     (Bii) Any screening deemed medically necessary for proper breast cancer screening in
accordance with applicable American College of Radiology guidelines including, but not limited
to, magnetic resonance imaging, ultrasound, or molecular breast imaging for any person who has
received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue.
     (b) This section shall not apply to insurance coverage providing benefits for: (1) hospital
Hospital confinement indemnity; (2) disability Disability income; (3) accident Accident only; (4)
long Long-term care; (5) Medicare supplement; (6) limited Limited benefit health; (7) specified
Specified disease indemnity; (8) sickness Sickness or bodily injury or death by accident or both;
and (9) other Other limited benefit policies.
     SECTION 2. Section 27-19-20 of the General Laws in Chapter 27-19 entitled "Nonprofit
Hospital Service Corporations" is hereby amended to read as follows:
     27-19-20. Mammograms and pap smears — Coverage mandated.
     (a) Subscribers to any nonprofit hospital service plan shall be afforded coverage under the
plan for mammograms and pap smears, in accordance with guidelines established by the American
Cancer Society.
     (b) Notwithstanding the provisions of this chapter, subscribers to any nonprofit hospital
service plan shall be afforded coverage for:
     (1) Two two (2) screening mammograms per year when recommended by a physician for
women who have been treated for breast cancer within the last five (5) years or who are at high risk
of developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple first-
degree relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical ductal
hyperplasia.; and
     (2) Any screening deemed medically necessary for proper breast cancer screening in
accordance with applicable American College of Radiology guidelines including, but not limited
to, magnetic resonance imaging, ultrasound, or molecular breast imaging for any person who has
received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue.
     SECTION 3. Section 27-20-17 of the General Laws in Chapter 27-20 entitled "Nonprofit
Medical Service Corporations" is hereby amended to read as follows:
     27-20-17. Mammograms and pap smears — Coverage mandated.
     (a) Subscribers to any nonprofit medical service plan shall be afforded coverage under the
plan for mammograms and pap smears, in accordance with guidelines established by the American
Cancer Society.
     (b) Notwithstanding the provisions of this chapter, subscribers to any nonprofit medical
service plan shall be afforded coverage for:
     (1) Two two (2) paid screening mammograms per year when recommended by a physician
for women who have been treated for breast cancer within the last five (5) years or who are at high
risk of developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple
first-degree relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical
ductal hyperplasia.; and
     (2) Any screening deemed medically necessary for proper breast cancer screening in
accordance with applicable American College of Radiology guidelines including, but not limited
to, magnetic resonance imaging, ultrasound, or molecular breast imaging for any person who has
received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue.
     SECTION 4. Section 27-41-30 of the General Laws in Chapter 27-41 entitled "Health
Maintenance Organizations" is hereby amended to read as follows:
     27-41-30. Mammograms and pap smears — Coverage mandated.
     (a) Subscribers to any health maintenance organization plan shall be afforded coverage
under that plan for mammograms and pap smears, in accordance with guidelines established by the
American Cancer Society.
     (b) Notwithstanding the provisions of this chapter, subscribers to any health maintenance
organization plan shall be afforded coverage for:
     (1) Two two (2) paid screening mammograms per year when recommended by a physician
for women who have been treated for breast cancer within the last five (5) years or who are at high
risk of developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple
first-degree relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical
ductal hyperplasia.; and
     (2) Any screening deemed medically necessary for proper breast cancer screening in
accordance with applicable American College of Radiology guidelines including, but not limited
to, magnetic resonance imaging, ultrasound, or molecular breast imaging for any person who has
received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue.
     SECTION 5. This act shall take effect on January 1, 2024.
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LC000686/SUB A
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