Senate Bill 264 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, including the addition of new definitions for various breast imaging techniques and the explicit inclusion of preferred provider plans in the coverage requirements. It maintains current law provisions for mammograms while enhancing coverage for diagnostic and supplemental screenings. The legislation aims to improve breast cancer detection and treatment by ensuring comprehensive insurance coverage for necessary examinations, thereby addressing the needs of high-risk individuals.

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