This bill aims to amend the Code of West Virginia by adding a new article that establishes cost-sharing requirements for diagnostic and supplemental breast examinations. It defines key terms such as "cost-sharing requirement," "diagnostic breast examinations," "health benefit policy," "insurer," and "supplemental breast examinations." The bill stipulates that if a health benefit policy covers screening, diagnostic, and supplemental breast examinations, it cannot impose any cost-sharing requirements on these services. Additionally, it allows the Commissioner of Insurance to propose legislative rules to implement these provisions.

Furthermore, the bill includes a provision that addresses potential conflicts with federal law regarding Health Savings Accounts (HSAs). If applying the no-cost-sharing requirement would make an individual ineligible for an HSA under federal law, the cost-sharing requirement will only apply to qualified High Deductible Health Plans after the enrollee meets the minimum deductible. The bill also clarifies that existing utilization review processes are not affected by this new legislation. Overall, the bill seeks to enhance access to necessary breast examinations by eliminating financial barriers for patients.

Statutes affected:
Introduced Version: 33-64-1