(TRENTON) – Healthcare providers who diagnose and treat breast cancer would be required to order concurrent mammograms and ultrasounds for women who have a family history or other risk factors of breast cancer under legislation introduced this week by Assemblywoman Annette Quijano and Senator Linda Greenstein.
The bill would require health insurers to cover the bilateral screenings for patients who have certain risk factors.
“I’ve personally known women who needed to battle their insurance companies to cover bilateral mammograms and ultrasounds, even though they know they are at high risk for breast cancer,” said Quijano (D-Union). “Breast cancer screenings are an essential component of women’s healthcare. We should be making it easier for women to access potentially life-saving cancer screenings, not putting up barriers to this essential care. The goal of this legislation is to give women peace of mind that they will never need to struggle with their insurer or provider to put their health first.”
“With breast cancer being the second leading cause of death among women each year, it is vital that our healthcare system provide bilateral ultrasounds to women receiving mammograms,” said Greenstein (D-Mercer/Middlesex). “Mammograms are not foolproof and can miss identifying potential cancers in women with dense breast tissue. All women should receive the proper care they need when it comes to identifying breast cancer and deserve to do so without fear of fighting with their health insurance provider in the process.”
Currently, insurers are required to provide coverage for an annual mammogram for women over 40 and at medically necessary intervals for women under 40 with a history of breast cancer. If a mammogram demonstrates extremely dense or an abnormal density of breast tissue, or a patient has a family history of breast cancer or other risk factors, insurers must provide coverage for an additional ultrasound evaluation.
Women who are already aware they have a family history of cancer, high breast density or other risk indicators could benefit from having a mammogram and ultrasound at the same time to ensure they receive a comprehensive screening. Mammograms, ultrasounds and other screenings can help detect breast cancer early, when it is easier to treat.
The measure also specifically requires health insurers to cover ultrasounds ordered concurrently with mammograms for women of color. African-American women are more likely to be diagnosed with breast cancer at a later stage and experience delays in treatment. Breast cancer mortality is higher among African-American women.
The legislation would take effect four months after enactment.