Bill > H0134

This bill adds a new chapter to Idaho law regarding breast cancer screening, requiring health benefit plans to provide coverage for supplemental breast screening for individuals at increased risk of breast cancer. The bill defines "supplemental breast screening" as a medically necessary examination using magnetic resonance imaging, contrast mammogram, or ultrasound when recommended by a physician. The coverage applies to health benefit plans offered by various entities like insurance companies, hospital service corporations, and managed care organizations. The bill mandates that these plans cover one supplemental breast screening annually for individuals with specific risk factors, including personal or family history of breast cancer, genetic predispositions, prior radiation therapy, high lifetime breast cancer risk (over 20%), or certain breast tissue densities. The legislation also identifies specific genetic mutations and syndromes that qualify for coverage, such as BRCA1/BRCA2 mutations and Li-Fraumeni syndrome. While the bill requires minimum coverage for these screenings, health plans can still apply standard deductible, copayment, and coinsurance provisions. The act is set to take effect on January 1, 2026, and is declared an emergency measure to improve early breast cancer detection and screening accessibility.

Health and Social Services

Health and Welfare Committee (H)

https://legislature.idaho.gov/sessioninfo/2025/legislation/H0134/