Assembly Bill 263 mandates that health insurance policies and self-insured 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, as defined by established medical guidelines. The bill specifies that these screenings must be covered without any cost-sharing requirements, although this limitation does not apply if it would affect eligibility for health savings accounts under federal law. Additionally, the bill maintains existing coverage requirements for mammograms while explicitly including preferred provider plans in these mandates.
The bill also introduces new definitions related to breast cancer screenings, including terms such as "breast magnetic resonance imaging," "breast tomosynthesis," and "diagnostic breast examination." It renumbers and amends existing statutes to incorporate these changes, ensuring that coverage is provided regardless of whether symptoms of breast cancer are present. The legislation is set to take effect for policy years beginning January 1 of the year following its enactment, with specific provisions for collective bargaining agreements.
Statutes affected: Bill Text: 40.51(8m), 40.51, 66.0137(4), 66.0137, 120.13(2)(g), 120.13, 609.80