Bill > S0197

This bill prohibits various types of health insurance providers, including group health plans, accident and sickness insurers, nonprofit hospital service corporations, nonprofit medical service corporations, and health maintenance organizations, from imposing any cost-sharing requirements (such as deductibles, copayments, coinsurance, or out-of-pocket expenses) for diagnostic and supplemental breast examinations. The bill defines diagnostic breast examinations as medically necessary breast imaging tests like mammography, MRI, or ultrasound used to evaluate abnormalities discovered during screening or through other examinations. Supplemental breast examinations are defined as additional breast imaging tests used to screen for breast cancer when no abnormality is detected, based on an individual's personal or family medical history or other risk factors. By eliminating cost-sharing for these types of breast examinations, the bill aims to remove financial barriers that might prevent individuals from obtaining important preventive and diagnostic breast cancer screenings. The legislation will take effect on January 1, 2026, and applies to both group and individual health insurance coverage.

Health and Social Services

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