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S T A T E O F N E W Y O R K
________________________________________________________________________
7280
2025-2026 Regular Sessions
I N S E N A T E
April 8, 2025
___________
Introduced by Sen. MARTINEZ -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to reducing the age of
receiving annual mammograms for persons enrolled in certain large
group policies
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Short title. This act shall be known and may be cited as
2 "Shannon's Law".
3 § 2. Subparagraph (A) of paragraph 11 of subsection (l) of section
4 3221 of the insurance law, as amended by chapter 424 of the laws of
5 2024, is amended to read as follows:
6 (A) Every insurer delivering a group or blanket policy or issuing a
7 group or blanket policy for delivery in this state that provides cover-
8 age for hospital, surgical or medical care shall provide the following
9 coverage for mammography screening for occult breast cancer:
10 (i) upon the recommendation of a physician, a mammogram, which may be
11 provided by breast tomosynthesis, at any age for covered persons having
12 a prior history of breast cancer or who have a first degree relative
13 with a prior history of breast cancer;
14 (ii) a single baseline mammogram, which may be provided by breast
15 tomosynthesis, for covered persons aged thirty-five through thirty-nine,
16 inclusive;
17 (iii) an annual mammogram, which may be provided by breast tomosynthe-
18 sis, for covered persons aged forty and older;
19 (iv) for large group policies that provide coverage for hospital,
20 surgical or medical care, an annual mammogram for covered persons aged
21 [thirty-five] THIRTY through thirty-nine, inclusive, upon the recommen-
22 dation of a physician, subject to the insurer's determination that the
23 mammogram is medically necessary; and
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11351-01-5
S. 7280 2
1 (v) upon the recommendation of a physician, screening and diagnostic
2 imaging, including diagnostic mammograms, breast ultrasounds, or magnet-
3 ic resonance imaging, recommended by nationally recognized clinical
4 practice guidelines for the detection of breast cancer. For the purposes
5 of this item, "nationally recognized clinical practice guidelines" means
6 evidence-based clinical practice guidelines informed by a systematic
7 review of evidence and an assessment of the benefits, and risks of
8 alternative care options intended to optimize patient care developed by
9 independent organizations or medical professional societies utilizing a
10 transparent methodology and reporting structure and with a conflict of
11 interest policy.
12 § 3. Subparagraph (D) of paragraph 1 of subsection (p) of section 4303
13 of the insurance law, as amended by chapter 424 of the laws of 2024, is
14 amended to read as follows:
15 (D) for large group contracts offered by a medical expense indemnity
16 corporation, a hospital service corporation or a health service corpo-
17 ration that provide coverage for hospital, surgical or medical care, an
18 annual mammogram for covered persons aged [thirty-five] THIRTY through
19 thirty-nine, inclusive, upon the recommendation of a physician, subject
20 to the corporation's determination that the mammogram is medically
21 necessary; and
22 § 4. This act shall take effect on the same date and in the same
23 manner as chapter 424 of the laws of 2024, takes effect and shall apply
24 to policies and contracts issued, renewed, modified, altered or amended
25 on or after such effective date.