This bill amends the Insurance Company Law of 1921 by repealing the existing provisions related to coverage for mammographic examinations and breast imaging, specifically Section 632, and replacing it with a new section, Section 632.1. The new section mandates that health insurance policies in Pennsylvania must 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 requires coverage for supplemental breast screenings and diagnostic breast examinations for individuals determined to be at least average risk for breast cancer.

The bill also outlines that the coverage must comply with existing laws and regulations, including the application of utilization review and the potential for deductibles or copayments for services beyond the minimum requirements. It defines terms such as "average risk," "diagnostic breast examination," and "supplemental breast screening," ensuring clarity in the coverage requirements. 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