The bill amends Section 514C.4A of the Iowa Code to establish new cost-sharing requirements for supplemental and diagnostic breast examinations. It introduces a definition of "cost-sharing," which encompasses any coverage limit, copayment, coinsurance, deductible, or other out-of-pocket costs imposed by health insurance policies. Additionally, the bill mandates that cost-sharing requirements for these examinations must be at least as favorable as those for screening mammograms. For individuals with high-deductible health plans, these requirements will only apply after the minimum deductible is met, with exceptions for preventive care services.

The provisions of this Act will take effect for all third-party payment provider contracts, policies, or plans that are delivered, issued for delivery, continued, or renewed in Iowa on or after January 1, 2026. This legislation aims to ensure equitable access to necessary breast health services by standardizing cost-sharing practices across different types of health insurance plans.

Statutes affected:
Introduced: 514C.4A
Reprinted: 514C.4A