BILL ANALYSIS �
SB 1538
Page 1
SENATE THIRD READING
SB 1538 (Simitian)
As Amended August 21, 2012
Majority vote
SENATE VOTE :39-0
HEALTH 15-0 APPROPRIATIONS 16-1
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|Ayes:|Monning, Logue, Ammiano, |Ayes:|Gatto, Harkey, |
| |Bonilla, Eng, Garrick, | |Blumenfield, Bradford, |
| |Hayashi, | |Charles Calderon, Campos, |
| |Roger Hern�ndez, Bonnie | |Davis, Fuentes, Hall, |
| |Lowenthal, Mansoor, | |Hill, Cedillo, Mitchell, |
| |Mitchell, Nestande, | |Nielsen, Norby, Solorio, |
| |V. Manuel P�rez, Smyth, | |Wagner |
| |Williams | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
| | |Nays:|Donnelly |
| | | | |
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SUMMARY : Requires health facilities at which mammography
examinations are performed to include a specified notice in the
summary of the written report that is sent to the patient in
order to notify patients who have dense breast tissue that they
may benefit from supplementary screening tests. Specifically,
this bill :
1)Requires a health facility at which a mammography examination
is performed to include a specified notice in the summary of
the written report sent to the patient, if the patient is
categorized by the facility as having heterogeneously dense
breasts or extremely dense breasts based on the Breast Imaging
Reporting and Data System established by the American College
of Radiology (ACR).
2)Specifies that the notice required in 1) above must state,
"Your mammogram shows that your breast tissue is dense. Dense
breast tissue is common and is not abnormal. However, dense
breast tissue can make it harder to evaluate the results of
your mammogram and may also be associated with an increased
risk of breast cancer. This information about the result of
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your mammogram is given to you to raise your awareness and to
inform your conversations with your doctor. Together, you can
decide which screening options are right for you. A report of
your results was sent to your physician."
3)Requires the provisions of this bill to become operative on
April 1, 2013.
4)Prohibits, prior to April 1, 2013, this bill from being
construed to create or impose liability on a health care
facility for failing to comply with its requirements.
5)Prohibits this bill from being deemed to create a duty of care
or other legal obligation beyond the duty to provide the
notice referenced in 2) above.
6)Prohibits this bill from being deemed to require a notice that
is inconsistent with the provisions of the federal Mammography
Quality Standards Act (MQSA).
7)Repeals this section on January 1, 2019, unless a later
enacted statute deletes or extends that date.
EXISTING LAW:
1)Requires, under federal regulations implementing the MQSA,
each facility that performs a mammography to send a report to
the referring physician that includes specified information.
A letter must also be sent to the patient informing her of the
results of the mammogram.
2)Requires health plans, individual or group disability
insurance policies, and self-insured employee welfare benefit
plans to provide coverage for mammograms, upon the referral of
a physician, nurse practitioner, or certified nurse-midwife,
for breast cancer screening and diagnostic purposes.
3)Requires individual or group disability insurance policies and
self-insured employee welfare benefit plans, upon referral, to
provide: a baseline mammogram for women ages 35 through 39,
inclusive; a mammogram for women ages 40 through 49,
inclusive, every two years or more, based on a physician's
recommendation; and, a mammogram every year for women age 50
and over.
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4)Licenses and regulates physicians and surgeons under the
Medical Board of California.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, state health care costs may increase as a result of
this bill, if it leads more women to discuss breast density with
their doctor and they decide to opt for additional screening and
follow-up tests. However, any impact will likely be mitigated
by other factors, including increasing awareness about breast
density among the medical community and the public, new
informational brochures produced by ACR that describe and
provide context about breast density, and changes in screening
recommendations based on a woman's breast cancer risk. Given
these dynamics and the non-prescriptive nature of the notice,
the direct fiscal impact of this bill is expected to be minor.
COMMENTS : According to the author, the National Cancer
Institute estimates that one in eight women will develop breast
cancer in their lifetime. The author maintains that women with
dense breast tissue are at four to six times greater risk of
developing breast cancer compared to women of the same age and
health. The author cites a Mayo Clinic study from January 2011
which reports that because dense breast tissue is white on a
mammogram and cancer is white on a mammogram, 75% of cancer is
missed in women with dense breast tissue by mammography alone.
The author maintains while federal law requires that a
radiologist performing a mammogram send a letter regarding the
results to the patient and a report to the referring physician,
only the report to the referring physician must contain
information about the patient's breast density. A national
survey, according to the author, found that 95% of women do not
know their breast density and that doctors have spoken to less
than 9% of patients about breast density. The author argues
that the lack of information provided to the patient regarding
breast density leaves the patient with a gap in information that
can be misleading for women with dense breast tissue. This
bill, the author asserts, will lead to more women surviving
breast cancer by helping to catch cancer early when it is most
treatable and curable.
Analysis Prepared by : Tanya Robinson-Taylor / HEALTH / (916)
319-2097
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FN: 0005293