On August 2, 2019, New York Governor signed S3852A, known as “Shannon’s Law”, which requires insurers to provide mammograms to certain covered New Yorkers. Shannon’s Law aims to give young women the opportunity to seek early detection of breast cancer by increasing access to annual breast exams for New Yorkers aged 35 through 39.
- Shannon’s Law requires insurers to cover mammograms for certain covered New Yorkers.
- Employers have no action items but should be aware of Shannon’s Law and communicate the new coverage to interested employees.
Which insurers are subject to Shannon’s Law?
Insurers delivering or issuing group coverage in New York that provides for hospital, surgical or medical care is subject to the law.
Under Shannon’s Law, who must insurers provide mammograms to?
Insurers who deliver or issue group coverage in New York must provide the following mammography screening for breast cancer:
- A mammogram, upon the recommendation of a physician:
- to covered persons of any age who have a prior history of breast cancer;
- to covered persons of any age who have a first degree relative with a prior history of breast cancer;
- A single baseline mammogram to covered persons aged 35 through 39;
- An annual mammogram:
- to covered persons aged 40 years or older;
- to covered persons aged 35 through 39 upon the recommendation of a physician, subject to the insurer’s determination that the mammogram is medically necessary.
Can insurers make the mammograms subject to annual deductibles or coinsurance?
No, the required mammograms cannot be subject to annual deductibles or coinsurance.
When must insurers comply with Shannon’s Law?
Insurance policies issued, renewed, modified, altered, or amended 30 days after the bill was signed into law, which is early to mid-September 2019, must comply with the new requirements.
How are employers affected by Shannon’s Law?
Employers are not subject to Shannon’s Law and have no action items but should be aware of how the law can affect their New York employees. Employers who purchase or modify group policies that are delivered to or issued out of New York after September 2019 should have the new mammogram coverage in their policies.
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