The bill amends the Public Health Service Act, thereby impacting the regulations around health insurance coverage related to breast examinations. By mandating coverage without cost-sharing, it is expected to increase the utilization of necessary diagnostic procedures. The act acknowledges that while it prohibits cost-sharing, it allows for certain prerequisites like prior authorization, which helps insurance providers manage approvals. Additionally, it ensures that state laws offering greater protections remain in effect, emphasizing the balance between federal and state health coverage regulations.
Summary
House Bill 3851, known as the Access to Breast Cancer Diagnosis Act of 2023, seeks to enhance access to necessary breast cancer diagnostic and supplemental examinations by removing cost-sharing obligations for patients. Specifically, it prohibits group health plans and health insurance issuers from imposing any deductibles, copayments, or coinsurance for these services. This legislation aims to alleviate financial barriers that can prevent individuals from seeking timely diagnosis and treatment for breast cancer, potentially leading to improved health outcomes and early detection among women and high-risk individuals.
Contention
Notable points of contention surrounding HB3851 may arise from differing opinions on the balance of cost-sharing models in health insurance. Supporters argue that removing these financial barriers is crucial in combating breast cancer effectively, particularly for populations that may be financially vulnerable. On the other hand, critics of such mandates might express concerns about the broader implications for insurance premiums and the financial sustainability of health plans, as higher coverage levels may lead to increased overall costs to insurers and, subsequently, policyholders.
Relating to the registration of diagnostic imaging equipment, the accreditation of diagnostic imaging facilities, and the regulation of diagnostic imaging providers; providing penalties.
Relating to the registration of diagnostic imaging equipment, the accreditation of diagnostic imaging facilities, and the regulation of diagnostic imaging providers; providing penalties.