Insights

Coverage of Breast Tomosynthesis


On Jan. 24, 2017, the Vermont Division of Insurance published Insurance Bulletin 191. The new bulletin addresses the use of breast tomosynthesis and states that insurance coverage may not be denied on the basis that breast tomosynthesis is experimental or investigational. Rather, because the U.S. Food and Drug Administration has approved its use and since Medicare provides reimbursement for it, breast tomosynthesis is no longer considered experimental or investigational and therefore coverage cannot be denied for that reason.

The bulletin contains no new employer obligations. Employers with fully insured plans in Vermont should be aware of the bulletin’s instructions relating to breast tomosynthesis in case any employee questions or insurer disputes arise.

Insurance Bulletin 191 »