This bill amends the Insurance Company Law of 1921 by repealing Section 632, which previously mandated coverage for mammographic examinations and breast imaging, and introduces a new Section 632.1 that expands and clarifies these coverage requirements. The new section requires health insurance policies in Pennsylvania to provide coverage without cost-sharing for annual mammographic examinations for individuals aged 40 and older, as well as for those under 40 upon a physician's recommendation. Additionally, it mandates coverage for supplemental breast screenings and diagnostic breast examinations for individuals determined to be at least at average risk for breast cancer.

The bill also specifies that the coverage must comply with existing laws and regulations, including the application of utilization review and the potential for deductibles or copayments beyond the minimum coverage. It defines terms such as "average risk," "diagnostic breast examination," and "supplemental breast screening," ensuring clarity in the types of services covered. The act will take effect 60 days after its passage, with specific provisions regarding its applicability to health insurance policies based on filing requirements.

Statutes/Laws affected:
Printer's No. 915 (Jun 06, 2025): P.L.682, No.284
Printer's No. 981 (Jun 23, 2025): P.L.682, No.284