Wisconsin Legislative Council
AMENDMENT MEMO
One Ea st Ma in Stre e t, Suite 401 • Ma dison, W I 53703 • (608) 266-1304 • le g.council@le gis.wisconsin.gov • http://www.le gis.wisconsin.gov/lc
Memo published: January 29, 2024 Contact: Kelly McGraw, Staff Attorney
2023 Assembly Bill 117 Assembly Amendment 1
2023 ASSEMBLY BILL 117
Generally speaking, the bill creates new coverage requirements for health insurance policies for certain
individuals for certain breast examinations, and corresponding cost-sharing limitations for those
examinations.
Specifically, the bill requires that a health insurance policy must provide coverage for “supplemental
breast screening examinations or diagnostic breast examinations for the detection of breast cancer,
including diagnostic mammography, breast ultrasounds, breast magnetic resonance imaging, or other
technologies as determined in accordance with applicable criteria and guidelines.”
However, this required coverage is limited to only two categories of individuals. Specifically, a health
insurance policy must cover either a supplemental breast screening examination or a diagnostic breast
examination for the following individuals:
An individual who is at increased risk of breast cancer, as determined in accordance with the most
recent applicable guidelines of the National Comprehensive Cancer Network; and
An individual who has heterogeneously or extremely dense breast tissue, as defined by the Breast
Imaging-Reporting and Data System, established by the American College of Radiology.
With one exception,
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the bill further provides that a health insurance policy may not impose a cost-
sharing amount on an individual in either of the two categories of individuals covered by the bill for
either a supplemental breast screening examination or a diagnostic breast examination.
The bill also requires coverage of those breast screenings by the state’s Medical Assistance program.
ASSEMBLY AMENDMENT 1
The amendment deletes definitions of various types of technologies and other references to those
technologies within the definitions of supplemental breast screening examinations and diagnostic
breast examinations.
The effect of the amendment is to limit the types of technology that must be covered for diagnostic and
supplemental breast screening examinations only to breast ultrasounds.
BILL HISTORY
Representative Gustafson offered Assembly Amendment 1 on January 9, 2024. On January 17, 2024,
the Assembly Committee on Health, Aging and Long-Term Care voted to recommend adoption of the
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SECTION 18 of the bill provides that the limitation on cost-sharing does not apply to the extent that the limitation would
result in ineligibility for a health savings account under the federal Internal Revenue Code. - 2 -
amendment on a vote of Ayes, 11; Noes, 5, and passage of the bill, as amended, on a vote of Ayes, 16;
Noes, 0.
For a full history of the bill, visit the Legislature’s bill history page.
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