The bill aims to enhance coverage for diagnostic and supplemental breast examinations by prohibiting cost sharing for these services under certain health plans. Specifically, for nongrandfathered health plans issued or renewed on or after January 1, 2024, health carriers are not allowed to impose cost sharing for supplemental and diagnostic breast examinations. However, if the health plan is a qualifying health plan for a health savings account, the carrier must set the cost sharing at a minimum level necessary to maintain the enrollee's ability to claim tax-exempt contributions. The bill defines "diagnostic breast examination" and "supplemental breast examination," ensuring clarity on what services are covered.

Additionally, the bill amends existing laws to reinforce the requirement for coverage of screening and diagnostic mammography services, which must be provided upon the recommendation of a physician or advanced registered nurse practitioner. The amendments clarify that standard policy provisions can still apply, but they explicitly exclude cost-sharing provisions as outlined in the new section of the bill. This legislative change is intended to align state law with federal mandates and improve access to essential breast health services for women in Washington.

Statutes affected:
Substitute Bill: 48.20.393, 48.21.225, 48.44.325, 48.46.275
Bill as Passed Legislature: 48.20.393, 48.21.225, 48.44.325, 48.46.275
Session Law: 48.20.393, 48.21.225, 48.44.325, 48.46.275