May 30, 2018

Vermont Expands Breast Screening Coverage Mandate

Gov. Phil Scott has signed HB 639, which requires health insurance plans in Vermont to cover additional breast imaging services without imposing cost-sharing requirements.

The bill stipulates that by October 1, 2018, the Department of Financial Regulation will issue a bulletin clarifying the coding structure for screening mammograms, ultrasounds and call-back screenings to health insurers.

The bulletin will specify that call-back mammograms and ultrasounds for patients with inconclusive results of a screening mammogram (BI-RADs 0), the presence of dense breast tissue or both findings shall be covered without patient cost-sharing.

The new law goes into effect January 1, 2019.