ENGR. S. A. TO ENGR. H. B. NO. 3504 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 ENGROSSED SENATE AMENDMENTS TO ENGROSSED HOUSE BILL NO. 3504 By: Provenzano, Bush, Miller, Ranson, Waldron, Manger, Luttrell, Baker, Fugate, Munson, Blancett, and West (Tammy) of the House and Stanley, Taylor, Garvin, Pederson, and Kirt of the Senate [ health insurance - mammography screenings - effective date ] AUTHOR: Add the following House Coauthors: Roe, Virgin, Dills, Townley, Roberts (Sean), Nollan, Bell, Crosswhite H ader, Pittman, Brewer, Sta rk, and Hasenbeck AUTHOR: Add the following Senate Coauthors: Floyd, Hicks, Kidd, Daniels, Boren, David, and Dossett (J.A .) AMENDMENT NO. 1. Page 1, line 23, insert after the word “and”, and before the word “appropriate”, the word “clinically” AMENDMENT NO. 2. Page 1, line 23, insert after the comma “,”, and before the word “as”, the words “as defined by current guidelines and ” AMENDMENT NO. 3. Page 3, lines 9 and 10, delete all new language AMENDMENT NO. 4. Page 3, line 10, insert after the word “cancer”, and before the period “.”, the words “and a diagnostic examination for breast cancer ” ENGR. S. A. TO ENGR. H. B. NO. 3504 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 AMENDMENT NO. 5. Page 3, line 22 1/2, insert a new subsection D to read as follows: “D. If application of this act would resu lt in health savings account ineligibility under Section 223 of the Federal I nternal Revenue Code, as amend ed, the provisions of this section shall only apply to health savings accounts with quali fied high deductible health plans with re spect to the deductible of such a plan after the enrollee has satisfied the minimum deductible. Provided, however, the provisions of this section shall apply to items or services that are preventive care pursuant to Section 223 (c) (2) (c) of the Federal Internal Revenue Code, as amended, regardless of whether the minimum deductible has been satisfie d.” and when the title is restored, amend the title to conform AMENDMENT NO. 6. Page 1, restore the amended title an d the enacting clause ENGR. S. A. TO ENGR. H. B. NO. 3504 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Passed the Senate the 20th day of April, 2022. Presiding Officer of the Senate Passed the House of Represe ntatives the ____ day of __________, 2022. Presiding Officer of the House of Representatives ENGR. H. B. NO. 3504 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 ENGROSSED HOUSE BILL NO. 3504 By: Provenzano, Bush, Miller, Ranson, Waldron, Manger, Luttrell, Baker, Fugate, Munson, Blancett, and West (Tammy) of the House and Stanley, Taylor, Garvin, Pederson, and Kirt of the Senate [ health insurance - mammography screenings - effective date ] BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: SECTION 1. AMENDATORY 36 O.S. 2021, Section 6060, is amended to read as follows : Section 6060. A. For the purposes of this section ,: 1. "Breast magnetic resonance imagin g" means a diagnostic tool used to produce detailed pictures of the structure of the breast; 2. "Breast ultrasound" means a noninvasive, dia gnostic imaging technique that uses high-frequency sound waves to pro duce detailed images of the breast; 3. "Diagnostic examination for breast cancer" means a medically necessary and appropr iate examination, as determined by a clinician ENGR. H. B. NO. 3504 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 who is evaluating the individual f or breast cancer, to evaluate the abnormality in the breast that is: a. seen or suspected from a screening examination for breast cancer, b. detected by another means of examination, or c. suspected based on the medica l history of family medical history of the indi vidual. This examination may include, but is not limited to, a diagnostic mammogram, breast magnetic resonance imaging, or a breast ultrasound; 4. "Diagnostic mammography" means a diagnostic to ol that: a. uses X-ray, and b. is designed to evaluate abnormality in a breast; 5. "Health benefit plan" means any plan or arrangement as defined in subsection C of Section 6060.4 of this title; 2. 6. "Low-dose mammography" means: a. the X-ray examination of the breast using equipment specifically dedicated for suc h purpose, with an average radiation exposure deliver y of less than one rad mid-breast and with two views for each breast, b. digital mammography, or c. breast tomosynthesis; 3. 7. "Breast tomosynthesis" means a radiologic mammography procedure involving the acquisition of projection images over a ENGR. H. B. NO. 3504 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 stationary breast to produce cross-sectional digital three- dimensional images of the breast from which breast cancer screening diagnoses may be made; and 8. "Screening mammography" means a radiologic procedure provided to a woman, who has no signs or symptoms of b reast cancer, for the purpose of early detection of breast cancer, including breast tomosynthesis . B. All health benefit plans shall include the coverage specified by this section for a low -dose mammography screening and a diagnostic examination for the presence of occult breast cancer. Such coverage shall not: 1. Be subject to the policy deductible, co -payments and co- insurance limits of the plan; or 2. Require that a female undergo a mammography scr eening at a specified time as a condition of payment. C. 1. Any female thirty-five (35) through thirty-nine (39) years of age shall be entitled pursuant to the provisions of this section to coverage for a lo w-dose mammography screening once every five (5) years. 2. Any female forty (40) years of age or ol der shall be entitled pursuant to the provisions of this section to coverage for an annual low-dose mammography screening. SECTION 2. This act shall become effective November 1, 2022. ENGR. H. B. NO. 3504 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Passed the House of Representatives the 8th day of March, 2022. Presiding Officer of the House of Representatives Passed the Senate the ___ day of __________, 2022. Presiding Officer of the Senate