The Breast Examination and Screening Transformation Act (BEST Act) seeks to improve insurance and Medicaid coverage for breast cancer screenings and examinations by amending several sections of the Revised Code. Key provisions include a revised definition of "screening mammography" to align with American College of Radiology guidelines, the introduction of terms like "diagnostic breast examination" and "supplemental breast cancer screening," and a mandate for health insurance policies to cover these services without cost-sharing requirements. The bill ensures that annual coverage for screening mammography and supplemental screenings is provided, particularly for individuals with dense breast tissue or increased risk factors, and clarifies that diagnostic breast examinations are covered for those with abnormalities detected in prior screenings.

Additionally, the bill updates existing laws to ensure comprehensive coverage under public employee benefit plans and Medicaid, specifying that these services must be performed in accredited facilities, while allowing diagnostic breast examinations to occur in non-accredited settings. It prohibits providers from seeking compensation beyond established payments, except for approved deductibles and copayments, and ensures that Medicaid recipients cannot be denied services due to inability to pay copayments. The bill also amends the Medicaid program's coverage of cytologic screenings, requiring them to be processed in certified laboratories, and repeals several existing sections of the Revised Code. Lastly, it mandates that the Director of Health and the Superintendent of Insurance notify relevant stakeholders about the new provisions within three months of enactment.

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