To amend title XXVII of the Public Health Service Act to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from imposing cost-sharing requirements with respect to diagnostic and supplemental breast examinations.
About This Bill
Committee
Latest Action · July 25, 2023
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
This bill requires group health insurance plans and individual health insurance policies to cover diagnostic and supplemental breast examinations without any out-of-pocket costs to patients, including no deductibles, copayments, or coinsurance. Diagnostic breast examinations are those used to evaluate suspected or detected abnormalities, while supplemental examinations are additional screenings for people at higher risk of breast cancer based on personal or family history. The legislation affects all health insurers and employers offering health coverage, though it allows insurers to use prior authorization and other utilization controls, and does not override state laws that provide greater protections. The bill's requirements take effect for health plans beginning January 1, 2024, and includes a special provision allowing high-deductible health savings accounts to remain eligible even without deductibles for these specific breast examinations. No new funding is appropriated by the bill, as it instead mandates insurance coverage changes.
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