Substitute Senate Bill No. 358 - Summary

• Requires individual and group health insurance policies to cover diagnostic and screening mammograms without copayments, coinsurance, or deductibles, with baseline mammograms available for women ages 35-39 or younger if at increased risk, and annual mammograms for women age 40+ or younger if at increased risk.

• Mandates coverage for additional breast cancer screening including ultrasound, magnetic resonance imaging (MRI), breast biopsies, prophylactic mastectomies for those with harmful genetic variants (BRCA1, BRCA2, or similar genes), and breast reconstructive surgery following mastectomy.

• Requires all mammography reports to include information about breast density and a notice informing patients about supplementary screening options such as ultrasound or MRI, with contact information for discussing results with their healthcare provider.

• Mandates coverage for genetic testing for individuals with family history of breast or ovarian cancer, routine ovarian cancer screening procedures including CA-125 testing and transvaginal ultrasound for those at risk, and CA-125 monitoring following ovarian cancer treatment.

• Applies to high-deductible health plans to the maximum extent permitted by federal law, with exemptions for plans used to establish medical savings accounts or health savings accounts under Internal Revenue Code sections 220 and 223; effective January 1, 2023.