February 06, 2019

States Consider Expanding Breast Tomosynthesis Coverage

The American College of Radiology is working with its state chapters to support legislative and regulatory efforts to expand access and insurance coverage of digital breast tomosynthesis (DBT). Pending state legislation mandating increased DBT screening and coverage is described below.

Hawaii

Hawaii introduced two sets of companion bills this session addressing breast tomosynthesis. Bills HB 481 and SB 1034 would amend the state’s existing health insurance mandate to specify that coverage of low-dose mammography includes coverage for digital mammography and breast tomosynthesis. Bills HB 689 and SB 1044 would extend the mandate to include coverage for 3-D mammography imaging for breast cancer patients every three months or as recommended by the patient's physician.

Iowa

In Iowa, Rep. Kirsten Running-Marquardt introduced HB 173, a bill that would mandate health care insurance coverage of mammography including three-dimensional mammography.

Massachusetts

State Sen. Joan B. Lovely pre-filed SD 358. It would mandate that insurance benefits provide a baseline mammogram, which may include tomosynthesis, for women ages of 35–39 and for a mammogram on an annual basis, which may include tomosynthesis, for women 40 or older. The benefits would also cover mammogram examinations, which may include tomosynthesis, for patients under 40 with a family history of breast cancer or other breast cancer risk factors.

Minnesota

In Minnesota, Rep. Kelly Morrison introduced HF 440, a bill that would mandate digital breast tomosynthesis coverage as a preventive service for patients at risk for breast cancer.

Oklahoma

Oklahoma’s State Sen. Paul Rosino introduced SB 922. It would mandate that patients with a prior history of breast cancer are entitled to coverage for mammography screening, which may be provided by breast tomosynthesis. Additionally, any woman 30 or older may be entitled to breast tomosynthesis as her annual mammography.