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 renumbers and amends several sections of existing statutes to incorporate these new requirements, including the addition of definitions for various breast imaging techniques and the clarification of coverage obligations. Notably, it maintains the current requirements for mammograms while explicitly including preferred provider plans under the new regulations. The legislation aims to enhance breast cancer screening accessibility and affordability, reflecting a commitment to improving women's health outcomes in Wisconsin.

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