House Bill 1138

AN ACT TO AMEND SECTION 83-9-108, MISSISSIPPI CODE OF 1972, TO PROVIDE THAT A GROUP HEALTH PLAN OR HEALTH INSURANCE ISSUER THAT OFFERS GROUP OR INDIVIDUAL HEALTH INSURANCE COVERAGE SHALL NOT IMPOSE ANY COST-SHARING REQUIREMENTS FOR BREAST CANCER SCREENINGS, DIAGNOSTIC BREAST EXAMINATIONS OR SUPPLEMENTAL BREAST EXAMINATIONS IF THE GROUP HEALTH PLAN OR HEALTH INSURANCE ISSUER PROVIDES THESE BENEFITS TO AN INDIVIDUAL ENROLLED UNDER SUCH PLAN OR COVERAGE; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. Section 83-9-108, Mississippi Code of 1972, is amended as follows:

83-9-108. (1) Every insurer shall offer in each group or individual policy, contract or certificate of health insurance issued or renewed for persons who are residents of this state, coverage for annual screenings by low-dose mammography for all women thirty-five (35) years of age or older for the presence of occult breast cancer within the provisions of the policy, contract or certificate. This coverage shall be offered on an optional basis, and each primary insured must accept or reject such coverage in writing and accept responsibility for premium payment.

(2) Such benefits shall be at least as favorable as for other radiological examinations and subject to the same dollar limits, deductibles and coinsurance factors. For purposes of this section, "low-dose mammography" means the x-ray examination of the breast using equipment dedicated specifically for mammography, including the x-ray tube, filter, compression device, screens, films and cassettes with a radiation exposure which is diagnostically valuable and in keeping with the recommended "Average Patient Exposure Guides" as published by the Conference of Radiation Control Program Directors, Inc.

(3) Except for cancer policies, nothing in this subsections (1) and (2) section shall apply to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care or limited benefit health insurance policies.

(4) The following words and phrases shall have the meanings as defined in this section unless the context clearly indicates otherwise:

(a) "Cost-sharing requirements" means a deductible, coinsurance, copayment and any maximum limitation on the application of such a deductible, coinsurance, copayment or similar out-of-pocket expense.

(b) "Diagnostic breast examination" means a medically necessary and appropriate examination of the breast, including such an examination using diagnostic mammography, breast magnetic resonance imaging or breast ultrasound, that is:

(i) Used to evaluate an abnormality seen or suspected from a screening examination for breast cancer; or

(ii) Used to evaluate an abnormality detected by another means of examination.

(c) "Supplemental breast examination" means a medically necessary and appropriate examination of the breast, including such an examination using breast magnetic resonance imaging or breast ultrasound, that is:

(i) Used to screen for breast cancer when there is no abnormality seen or suspected; and

(ii) Based on personal or family medical history or additional factors that may increase the individual's risk of breast cancer.

(5) A group health plan or health insurance issuer that offers group or individual health insurance coverage shall not impose any cost-sharing requirements for breast cancer screenings, diagnostic breast examinations or supplemental breast examinations if the group health plan or health insurance issuer provides these benefits to an individual enrolled under such plan or coverage.

SECTION 2. This act shall take effect and be in force from and after July 1, 2023.