The bill establishes new provisions for coverage of mammograms and supplemental breast cancer screenings under the Medicaid program and various health insurance policies in Florida. It creates a new section, 409.9064, which mandates that the Agency for Health Care Administration provide coverage for yearly mammograms and supplemental screenings for women aged 25 to 40 who meet certain criteria, such as having dense breast tissue or a family history of breast cancer. The bill also requires the agency to seek federal approval if necessary for implementation. Additionally, it amends existing statutes (ss. 627.6418, 627.6613, and 641.31095) to include definitions and coverage requirements for supplemental breast cancer screenings, which are deemed medically necessary by a healthcare provider.

Key changes include the definition of "supplemental breast cancer screening" and the requirement for insurance policies to cover one mammogram and one supplemental screening each year for eligible women. The bill specifies that coverage must be provided for these services starting July 1, 2025, and outlines the conditions under which these screenings are necessary. It also clarifies that the coverage is subject to the same deductible and coinsurance provisions as other outpatient services, while ensuring that insurers offer this coverage without it being subject to deductibles or copayments if an additional premium is paid.

Statutes affected:
H 187 Filed: 627.6418, 627.6613, 641.31095