Cuomo: Insurers Must Cover Medically Necessary 3D Mammograms

Cuomo: Insurers Must Cover Medically Necessary 3D Mammograms

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From now on, health insurers are required under New York insurance law to provide "medically necessary" coverage for 3D mammograms without co-pays, coinsurance, or deductibles, Governor Cuomo announced this week.

The change results from a law Cuomo signed in 2016.

It was hailed by officials at Lewis County General Hospital, which has one of the area's two 3D mammogram set-ups.They credit state senator Joe Griffo with helping to secure the change.

 "This legislation is going to ensure that everyone has the highest level of breast cancer screening possible, regardless of their ability to pay," said Rob Pfeiffer, the hospital's director of radiology.

3D mammography is widely held to be more accurate than traditional "2D" mammography, because it collects multiple images to create a detailed 3D picture of a breast. Advocates say the technology helps doctors catch breast cancers much sooner.

"We're finding that we can find breast cancer when it's smaller, when it's localized in the breast before it spreads to different organs and the bones," Pfeiffer said.

Pfeiffer estimates that 20-25 percent of women tested have opted to not get 3D mammograms in the past because of cost.

The legislation signed by Governor Cuomo includes:
  
•    Eliminating annual deductibles, co-payments, and co-insurance payments ("cost-sharing") for all screening mammograms, including those provided to women more frequently than current federal screening guidelines such as annual mammograms for women in their forties; 
•    Eliminating cost-sharing for diagnostic imaging for breast cancer, including diagnostic mammograms, breast ultrasounds, and breast MRIs.  As a result, women in need of tests other than standard mammograms do not have to pay any additional out-of-pocket expenses for these most common diagnostic tests; 
•    Requiring 210 hospitals and hospital extension clinics to offer extended hours of screening for at least four hours per week to help women who have difficulty scheduling mammograms during the typical 9 a.m. to 5 p.m. workday. These hours include 7 a.m. to 9 a.m. and 5 p.m. to 7 p.m. Monday through Friday, and 9 a.m. to 5 p.m. Saturday or Sunday; 
 

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