Virginia HB 579: Health insurance; coverage for mammograms.

Bill Text

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2021 SESSION

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20102080D

HOUSE BILL NO. 579 

Offered January 8, 2020 

Prefiled January 6, 2020 

A BILL to amend and reenact � 38.2-3418.1 of the Code of 
 Virginia, relating to health insurance; coverage for mammograms. 
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Patrons-- Guzman, Coyner, Delaney, Hope, Levine, Mugler, Rasoul and 
Samirah; Senator: Morrissey 

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Referred to Committee on Labor and Commerce 

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Be it enacted by the General Assembly of Virginia:

1. That � 38.2-3418.1 of the Code of Virginia is amended and 
 reenacted as follows:

� 38.2-3418.1. Coverage for mammograms.

A. 1. 
 Notwithstanding the provisions of � 38.2-3419, each insurer proposing to issue 
 individual or group accident and sickness insurance policies providing 
 hospital, medical and surgical or major medical coverage on an expense incurred 
 basis, each corporation providing individual or group accident and sickness 
 subscription contracts, and 
 each health maintenance organization providing a health care plan for health 
 care services shall provide, subject to such dollar 
 limits, deductibles, and coinsurance factors as are no less favorable than for 
 physical illness generally, coverage under such policy, 
 contract, or plan delivered, issued for 
 delivery, or renewed in this the 
 Commonwealth on and after:

1. From 
 July 1, 1996, until January 1, 2021, for 
 low-dose screening mammograms for determining the presence of occult breast 
 cancer covered individuals. 
 Such coverage shall make available one screening such mammogram to persons covered individuals 
 age thirty-five 35 through 
 thirty-nine 39, one 
 such mammogram biennially to persons covered individuals 
 age forty 40 
 through forty-nine 49, and one such mammogram 
 annually to persons covered individuals 
 age fifty 50 
 and over and may be limited to a benefit of fifty dollars $50 per mammogram subject to such dollar limits, deductibles, and coinsurance factors as are no less favorable 
 than for physical illness generally; and

2. On and after January 1, 
 2021, for low-dose screening mammograms for covered 
 individuals as follows:

a. If a 
 covered individual does not have a family history of breast cancer:

(1) One low-dose 
 screening mammogram to covered individuals age 35 through 39;

(2) One low-dose 
 screening mammogram biennially to covered individuals age 40 
 through 49; and

(3) One 
 low-dose screening mammogram annually to covered individuals age 50 and over; or

b. If a 
 covered individual has a family history of breast cancer:

(1) One low-dose 
 screening mammogram annually to any covered individual age 
 30 through age 49; however, such 
 coverage shall commence at an age earlier than 30 if the 
 covered individual's mother was first diagnosed 
 with breast cancer at an age earlier tha