CA SB974

Requires health care service plans, disability insurance policies, and self-insured employee welfare benefit plans issued or renewed on or after January 1, 2024, to cover screening mammography and diagnostic breast imaging without cost sharing.

Covers medically necessary diagnostic breast imaging including breast MRI, ultrasound, and diagnostic mammography, as well as diagnostic imaging following abnormal mammography results and for enrollees with breast cancer risk factors.

Applies coverage requirements consistent with nationally recognized evidence-based clinical guidelines and requires plans to arrange out-of-network services if unavailable within network to ensure timely access.

For high deductible health plans, cost-sharing waiver applies only after the enrollee's annual deductible is satisfied.

Excludes specialized health insurance, Medicare supplement insurance, CHAMPUS supplement insurance, TRI-CARE supplement insurance, hospital indemnity, accident-only, and specified disease insurance from these requirements.