More states seek to expand mammography, DBT coverage

A number of U.S. states have pending legislation that would expand access to and coverage of mammography and digital breast tomosynthesis (DBT) screening, according to the American College of Radiology (ACR).

For example, Connecticut has pending bills that would require insurers to cover annual mammograms for women with a personal or family history of breast cancer. The state also has legislation that would expand coverage to include diagnostic mammograms for women who have been diagnosed with breast cancer; prohibit charging a co-payment or cost-sharing for both routine and baseline mammograms; and require providers to lower the costs of mammography, breast ultrasound, and breast MRI.

In addition, Hawaii has pending legislation that would compel insurers to cover breast cancer screening provided by both mammography and tomosynthesis, while Illinois has a senate bill in the works that would require insurance coverage of mammography screening for all women 35 or older.

Other pending legislation includes the following:

  • An Iowa representative has introduced a bill mandating that insurers cover mammography, including DBT.
  • A Massachusetts senator has filed a bill that would direct insurers to cover baseline mammography, which may include tomosynthesis, for women 35 to 39, as well as annual mammography, which may also include DBT, for women 40 or older.
  • Minnesota has a pending bill that would require insurers to cover DBT exams as a preventive service for patients at risk for breast cancer.
  • Nebraska has a bill in the works that would require coverage for breast cancer screening.
  • New Jersey has pending legislation that would mandate mammography coverage for women younger than 40 who lack access to their family medical history due to adoption.
  • A New York senator has introduced a bill that would lower the eligibility age for an annual mammogram from 40 to 30 years.
  • In Oklahoma, legislation would require insurers to cover mammography -- or DBT -- screening for patients with a prior history of breast cancer.
  • A Pennsylvania representative has introduced legislation that would expand the age eligibility for breast cancer screening services from 40 to 49 years to 30 to 65 years.
  • In Texas, a bill has been introduced that would require insurers who cover screening mammography to also cover diagnostic mammography.
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