Diagnostic Mammography Coverage Required

On June 15, 2019, Gov. Abbott signed HB 170 into law. This law requires plans that provide coverage for a screening mammogram to provide coverage for a diagnostic mammogram that is no less favorable than the coverage for a screening mammogram. The bill defines “diagnostic mammogram” as an imaging examination designed to evaluate a subjective or objective abnormality detected by a physician in a breast, an abnormality seen by a physician on a screening mammogram, an abnormality previously identified by a physician as probably benign in a breast for which follow-up imaging is recommended by a physician, or an individual with a personal history of breast cancer.

This law takes effect on September 1, 2019, and will apply to any health benefit plan that is delivered, issued for delivery, or renewed on or after January 1, 2020.

HB 170 »