HB 564 Summary

• Expands mandatory insurance coverage for mammogram screenings to include women ages 35-39 (baseline annual mammogram), women over age 30 deemed by a licensed physician to have above-average breast cancer risk, and women of any age for supplemental imaging deemed medically necessary by American College of Radiology guidelines.

• Requires health insurance policies to cover digital mammography and digital breast tomosynthesis (3D breast imaging) as part of low-dose mammography screening, not just traditional mammography.

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

• Mandates health care providers be reimbursed at rates reflecting actual resource costs specific to each imaging modality, including any increased costs after January 1, 2021, with coverage terms no less favorable than other radiological examinations.

• Takes effect July 1, 2021, and applies to all accident and health insurance policies delivered or issued in Hawaii.