Relating to the coverage by certain health benefit plans of mammograms performed by certain health care providers.
Impact
The passage of HB438 signifies a crucial step towards enhancing preventative healthcare measures for women, particularly in the early detection of breast cancer. By ensuring that low-dose mammography is covered without financial penalties relative to other similar procedures, the bill is expected to improve access to necessary screenings, thus potentially leading to earlier diagnoses and better health outcomes. However, it is noted that the law applies only to plans that are issued or renewed after January 1, 2018, leaving older policies unaffected by these changes.
Summary
House Bill 438 aims to amend the Insurance Code to require certain health benefit plans to provide coverage for low-dose mammography for women aged 35 years and older. This bill mandates that such health plans must cover annual screenings for the detection of breast cancer, ensuring that coverage is not less favorable than that of other radiological examinations. Importantly, it applies to both individual and group health insurance policies, thereby aligning the coverage requirements across different types of health plans.
Contention
While the bill has been broadly supported on the grounds of enhancing women's health services, there are concerns regarding its implementation, specifically relating to the potential for health plans to impose prior approval requirements for screenings. This could lead to bureaucratic hurdles for patients seeking preventative care. Furthermore, there may be debates on how these regulations might affect smaller health insurance providers and the financial sustainability of underwriting such coverage without adjustments to their pricing models.