The Senate today (January 29) approved measures to help cancer patients access potentially lifesaving drugs and require insurers to cover supplemental screenings for women at high risk for breast cancer, according to Senator Dan Laughlin.
Under House Bill 427, the Fair Access to Cancer Treatment Act, health insurance policies that cover treatments for stage four metastatic cancers will not be able to limit or exclude innovative drugs for those patients if the drugs have been approved by the U.S. Food and Drug Administration for this use and are consistent with best practices. Patients no longer will have to first demonstrate that they failed to respond to a different drug or drugs before they are provided coverage.
Senate Bill 595 amends the state Insurance Company Law to extend mandated insurance coverage to ultrasound screening and magnetic resonance imaging (MRI) if a mammogram demonstrates extremely dense breast tissue. Both cancer and density appear white on a mammogram, so detecting tumors is much more difficult in denser breasts without further screening provided by an ultrasound or an MRI. Women who have extremely dense breast tissue are four to six times more likely to develop breast cancer. Currently, insurance companies do not cover these extra screening costs for women who are at an increased risk.
Additionally, insurance coverage will also be extended if a woman is believed to be at increased risk for breast cancer due to family history or prior personal history of breast cancer, positive genetic testing or other indications.
Contact: Matt Azeles mazeles@pasen.gov (717) 787-8927