Memorandum in Opposition
|For Immediate Release: May 16, 2023
Re: A.5729 (Paulin)/S.6146 (Cleare) — AN ACT to amend the insurance law, in relation to requiring certain insurers to provide coverage for tattooing performed by a physician as part of breast reconstruction surgery.
This legislation, A.5729/S.6146, would require insurers to provide coverage for tattooing of the nipple-areolar complex pursuant to or as part of breast reconstruction surgery. While well intentioned, this bill is unnecessary and, accordingly, the New York Health Plan Association (HPA) opposes the legislation.
New York’s health plans support early detection and early treatment of breast cancer (and all cancers), and provide comprehensive care that includes breast reconstructive surgery following a mastectomy or partial mastectomy. Existing New York and federal law both require that coverage be provided for all stages (emphasis added) of breast reconstruction. Specifically, New York Insurance Law (§§ 3216(i)(20)(A), 3221(k)(10)(A), and 4303(x)(1)) and the Employee Retirement Income Security Act (ERISA) state insurers must cover “all stages of reconstruction of the breast on which the mastectomy or partial mastectomy has been performed and surgery and reconstruction of the other breast to produce a symmetrical appearance of the breast or chest wall on which the mastectomy or partial mastectomy has been performed.” This coverage is also referenced in the federal Women’s Health and Cancer Rights Act of 1998. Nipple/areola reconstruction and tattooing is considered a part of the entire reconstruction process.
Given the coverage requirements that exist under current law, as well as New York’s strong health care consumer protection rights that provide ample recourse for consumers to file grievances and request an appeal when there are disagreements, A.5729/S.6146 is unnecessary. We urge the legislature to reject this legislation.