Utah 2025 Regular Session

Utah House Bill HB0314 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	01-23 14:51 H.B. 314
2	2	1
3	3	Breast Cancer Prevention Modifications
4	4	2025 GENERAL SESSION
5	5	STATE OF UTAH
6	6	Chief Sponsor: Jennifer Dailey-Provost
7	7	2
8	8
9	9	3
10	10	LONG TITLE
11	11	4
12	12	General Description:
13	13	5
14	14	This bill amends provisions related to health insurance and breast examinations that detect
15	15	6
16	16	breast cancer.
17	17	7
18	18	Highlighted Provisions:
19	19	8
20	20	This bill:
21	21	9
22	22	▸ defines terms; and
23	23	10
24	24	▸ prohibits a health benefit plan from implementing a cost-sharing requirement for certain
25	25	11
26	26	breast examinations that detect breast cancer.
27	27	12
28	28	Money Appropriated in this Bill:
29	29	13
30	30	None
31	31	14
32	32	Other Special Clauses:
33	33	15
34	34	None
35	35	16
36	36	Utah Code Sections Affected:
37	37	17
38	38	ENACTS:
39	39	18
40	40	31A-22-630.1, Utah Code Annotated 1953
41	41	19
42	42
43	43	20
44	44	Be it enacted by the Legislature of the state of Utah:
45	45	21
46	46	Section 1. Section 31A-22-630.1 is enacted to read:
47	47	22
48	48	31A-22-630.1 . Breast exam cost sharing.
49	49	23
50	50	(1) As used in this section:
51	51	24
52	52	(a) "Cost-sharing requirement" means any copayment, coinsurance, deductible, or
53	53	25
54	54	annual limitation on out-of-pocket expenses required by a health benefit plan for a
55	55	26
56	56	specific health care service covered by the health benefit plan.
57	57	27
58	58	(b)(i) "Breast examination" means a medical examination of the breast conducted by
59	59	28
60	60	a health care professional.
61	61	29
62	62	(ii) "Breast examination" includes:
63	63	30
64	64	(A) contrast-enhanced mammography;
65	65	31
66	66	(B) diagnostic mammography; H.B. 314 01-23 14:51
67	67	32
68	68	(C) breast magnetic resonance imaging; and
69	69	33
70	70	(D) breast ultrasound.
71	71	34
72	72	(c) "Diagnostic breast examination" means a medically necessary breast examination
73	73	35
74	74	that is used to evaluate an abnormality that was detected or suspected after another
75	75	36
76	76	means of examination, including a previous breast examination.
77	77	37
78	78	(d) "Supplemental breast examination" means a medically necessary breast examination
79	79	38
80	80	that is used to screen for breast cancer:
81	81	39
82	82	(i) when there is no prior indication that a breast health abnormality exists or is
83	83	40
84	84	suspected;
85	85	41
86	86	(ii) based on personal or family medical history; or
87	87	42
88	88	(iii) based on additional factors that increase an individual's risk of breast cancer.
89	89	43
90	90	(2) A health benefit plan that provides benefits with respect to diagnostic breast
91	91	44
92	92	examinations or supplemental breast examinations may not require an enrollee to pay a
93	93	45
94	94	cost-sharing requirement for a diagnostic breast examination or a supplemental breast
95	95	46
96	96	examination.
97	97	47
98	98	(3) A diagnostic breast examination or a supplemental breast examination is medically
99	99	48
100	100	necessary if the examination is provided in accordance with the National
101	101	49
102	102	Comprehensive Cancer Network Guidelines.
103	103	50
104	104	Section 2. Effective Date.
105	105	51
106	106	This bill takes effect on May 7, 2025.
107	107	- 2 -