Assembly Bill 263 mandates that health insurance policies and self-insured governmental health plans provide coverage for diagnostic breast examinations and supplemental breast screening examinations for individuals at increased risk of breast cancer or those with dense breast tissue. The bill specifies that these screenings must adhere to the latest guidelines from the National Comprehensive Cancer Network and the Breast Imaging-Reporting and Data System. Additionally, the Medical Assistance program is required to cover these screenings, ensuring access for individuals with limited financial resources. The bill also prohibits cost-sharing for these examinations, although it allows for exceptions related to health savings accounts under federal law.

The bill includes several amendments and new definitions related to breast cancer screenings, such as defining various diagnostic tools like breast magnetic resonance imaging, breast ultrasound, and breast tomosynthesis. It renumbers existing statutes and clarifies that the current coverage requirements for mammograms remain unchanged, while explicitly including preferred provider plans under the new regulations. The legislation aims to enhance access to critical breast cancer screenings and ensure that financial barriers do not prevent individuals from receiving necessary medical care.

Statutes affected:
Bill Text: 40.51(8m), 40.51, 66.0137(4), 66.0137, 120.13(2)(g), 120.13, 609.80