This bill introduces six new sections to the Code of West Virginia that establish cost-sharing requirements for diagnostic and supplemental breast examinations. It mandates that health benefit policies providing coverage for these examinations cannot impose any cost-sharing requirements, such as deductibles or copayments. The bill defines key terms related to breast examinations and clarifies that existing utilization reviews will not be affected by these provisions. It also addresses potential conflicts with federal law regarding Health Savings Accounts, ensuring that the no-cost-sharing requirement applies only after the minimum deductible has been met for certain high deductible health plans.

Additionally, the bill empowers the Insurance Commissioner to propose rules for legislative approval to implement these provisions in accordance with guidelines established by professional medical organizations, such as the National Comprehensive Cancer Network. The new sections aim to enhance access to necessary breast health services without imposing financial barriers on patients, ensuring that if a health benefit policy includes coverage for these examinations, it cannot require any out-of-pocket expenses from the insured.

Statutes affected:
Introduced Version: 5-16-7h, 33-15-4y, 33-16-3ii, 33-24-7z, 33-25-8w, 33-25A-8z