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Committee advances bill to clarify no‑cost coverage for diagnostic and supplemental breast imaging
Summary
Senate Bill 296 would clarify that medically necessary diagnostic and supplemental breast exams tied to screening and high‑risk surveillance are covered without cost sharing and specify eligible imaging modalities; committee forwarded it to the Committee of the Whole.
The House Health & Human Services Committee advanced Senate Bill 296 to the Committee of the Whole after sponsors said the bill clarifies and expands existing state law to ensure no cost‑sharing for medically necessary diagnostic and supplemental breast imaging used to rule out or confirm breast cancer.
Representative Byrd, a sponsor, told the committee the 2019 statute intended to remove financial barriers for high‑risk patients but has proven confusing to patients and providers. The bill reorganizes the definitions, names specific diagnostic and supplemental modalities (including contrast‑enhanced mammography and MRI where clinically indicated), and clarifies that no cost sharing applies to diagnostic and supplemental imaging following screening or in the context of high‑risk surveillance.
Supporters, including Heidi Morgan of Susan G. Komen, told the committee that diagnostic follow‑up is essential to early detection and that out‑of‑pocket cost can deter patients from obtaining recommended imaging. Morgan said earlier detection lowers treatment costs and improves survival. Committee members asked about scope and modalities; sponsors said the measure uses nationally recognized guidelines (NCCN, ACR) to define clinically necessary imaging and applies existing high‑deductible plan language where required.
The committee adopted no amendments and sent the bill to the Committee of the Whole with a favorable recommendation; the roll call recorded a unanimous committee vote in favor.
Why it matters: Testimony cited studies showing patients sometimes skip recommended follow-up imaging because of deductible concerns. Sponsors emphasized the bill’s intent to make coverage language clearer for patients and to align statutory language with clinical guidelines.
What’s next: The measure proceeds to the Committee of the Whole and, if passed there, would be implemented via health plans regulated by the Division of Insurance.
