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New York Mandates Medically Necessary Mammograms

New York’s governor has signed Shannon’s Law which is a state law that requires large group insurance companies in the State of New York to cover annual mammogram screenings for women aged 35 to 39 when the screening is deemed “medically necessary.”

Currently, most insurance companies are only required to cover annual mammogram screenings for women who are over the age of 40. Shannon’s Law, however, is effective September 1, 2019, and applies to policies and contracts issued, renewed or modified on or after September 1.

The passage of New York’s Shannon’s Law represents a trend towards greater protections for women’s health care, particularly as it relates to breast cancer. Federal law already provides for certain protections under the Women’s Health and Cancer Rights Act for mastectomies and reconstructive surgery.

Additionally, in August 2019, the U.S. Preventive Services Task Force (USPSTF) recommended a "B" rating for Breast Cancer Gene (BRCA) assessment and genetic screening, which means plan sponsors must incorporate the BRCA preventive care recommendations into their plan design at no cost-sharing as it does with other preventive care under the Affordable Care Act (ACA).

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