The Breast Examination and Screening Transformation Act (BEST Act) proposes significant amendments to the Revised Code to improve insurance and Medicaid coverage for breast cancer screenings and examinations. Key changes include the alignment of the definition of "screening mammography" with American College of Radiology guidelines and the introduction of new terms such as "diagnostic breast examination" and "supplemental breast cancer screening." The bill mandates that health insurance policies cover these screenings without cost-sharing requirements, ensuring that individuals can access necessary services without financial barriers. It also specifies that coverage for screening mammography and supplemental screenings must be provided annually, particularly for individuals with dense breast tissue or increased risk factors, and clarifies that diagnostic breast examinations must be covered for those with abnormalities detected in prior screenings.

Additionally, the bill amends existing laws to ensure comprehensive coverage for breast cancer screening and diagnostic services under public employee benefit plans and Medicaid programs, prohibiting cost-sharing for recipients. It introduces new definitions for relevant terms and specifies that Medicaid recipients cannot be denied services due to an inability to pay copayments. The bill also outlines that cytologic screenings will only be covered if processed in certified laboratories and repeals several existing sections of the Revised Code. Furthermore, it requires the Director of Health and the Superintendent of Insurance to notify relevant stakeholders about the new provisions within three months of enactment, thereby promoting better access to essential breast cancer detection and diagnosis services.

Statutes affected:
As Introduced: 1751.62, 3923.52, 3923.53, 5162.20, 5164.08