WV HB5241

Requires insurance coverage for one baseline mammogram for women ages 30-39, annual mammograms for women 40 and over, and mammograms at medically necessary intervals for women under 40 with family history or other risk factors.

Mandates coverage for comprehensive breast ultrasound screening when mammograms show heterogeneous or dense breast tissue, or when a woman has increased breast cancer risk due to family history, prior breast cancer, or positive genetic testing.

Applies to West Virginia Public Employees Insurance, accident and sickness insurance, group insurance, hospital/medical service corporations, health care corporations, and health maintenance organizations.

Requires FDA-certified mammography facilities to notify patients of their breast density classification based on the American College of Radiology's Breast Imaging Reporting and Data System, along with information about potential risks and benefits of additional screening.

Takes effect for policies delivered, issued, reissued, or extended in West Virginia on or after January 1, 2026, or when policy terms or premiums are changed thereafter.