HB 19-1301 Summary

• Requires health insurance plans to cover annual preventive breast cancer screening using noninvasive imaging modalities appropriate for each individual's breast health needs, as determined by their provider and within American College of Radiology or National Comprehensive Cancer Network guidelines.

• Requires coverage of diagnostic and supplemental breast imaging within the same calendar year at no cost-sharing if recommended by a provider and within appropriate use guidelines.

• Expands coverage to include annual breast cancer screening for individuals with at least one risk factor, including family history, age 40 or older, or increased lifetime risk determined by risk assessment models (Tyrer-Cuzick, BRCAPRO, Gail, or other clinically appropriate models).

• Defines "breast cancer screening study" and "breast imaging" to include mammograms with or without clinical exams and medically recommended subsequent noninvasive imaging modalities for early detection.

• Takes effect January 1, 2021, for policies and contracts issued or renewed on or after that date.