HB 564 Summary

• Expands insurance coverage for mammogram screenings to include women ages 35-39 (baseline annual mammogram), women 40+ (annual mammogram), women over 30 deemed by a physician to have above-average breast cancer risk (annual mammogram), and women of any age with personal or family history of breast cancer or deemed to need supplemental imaging per American College of Radiology guidelines.

• Requires health insurance plans to cover digital mammography and digital breast tomosynthesis (3D breast imaging) as part of low-dose mammography screening, with coverage subject to the same deductibles and co-payments as other radiological examinations.

• Defines "digital breast tomosynthesis" as a radiologic procedure creating a three-dimensional representation of the breast from multiple low-dose two-dimensional x-ray projections at different angles.

• Requires health care providers to be reimbursed at rates accurately reflecting resource costs specific to each imaging modality, including increased costs after January 1, 2021.

• Takes effect July 1, 2021.