House Bill 1144

AN ACT TO PROHIBIT GROUP HEALTH PLANS AND HEALTH INSURANCE ISSUERS THAT PROVIDE BENEFITS WITH RESPECT TO SCREENING, DIAGNOSTIC BREAST EXAMINATIONS AND SUPPLEMENTAL BREAST EXAMINATIONS FURNISHED TO INDIVIDUALS ENROLLED UNDER SUCH PLANS FROM IMPOSING ANY COST-SHARING REQUIREMENTS FOR THOSE SERVICES; TO AMEND SECTION 83-9-108, MISSISSIPPI CODE OF 1972, TO CONFORM TO THE PRECEDING PROVISIONS; AND FOR RELATED PURPOSES.

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

SECTION 1. As used in this section, the following terms shall be defined as provided in this subsection:

(a) "Cost-sharing requirements" means a deductible, coinsurance, copayment or similar out-of-pocket expense.

(b) "Diagnostic breast examinations" means a medically necessary and appropriate (in accordance with National Comprehensive Cancer Network Guidelines) examination of the breast, including, but not limited to, such an examination using contrast-enhanced mammography, 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 examinations" means a medically necessary and appropriate (in accordance with National Comprehensive Cancer Network Guidelines) examination of the breast, including, but not limited to, such an examination using contrast-enhanced mammography, diagnostic mammography, 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.

(2) If a group health plan, or a health insurance issuer offering group or individual health insurance coverage, provides benefits with respect to screening, diagnostic breast examinations and supplemental breast examinations furnished to an individual enrolled under such plan, such plan shall not impose any cost-sharing requirements for those services.

(3) If under federal law, application of subsection (2) of this section would result in health savings account ineligibility under Section 223 of the federal Internal Revenue Code, this requirement shall apply only for health savings account-qualified high deductible health plans with respect to the deductible of such a plan after the enrollee has satisfied the minimum deductible under Section 223, except for with respect to items or services that are preventive care pursuant to Section 223(c)(2)(C) of the federal Internal Revenue Code, in which case the requirements of subsection (2) shall apply regardless of whether the minimum deductible under Section 223 has been satisfied.

SECTION 2. 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 section shall apply to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care or limited benefit health insurance policies.

(4) The provisions of Section 1 of this act shall be applicable to the coverage for mammography screenings provided by insurers under the provisions of this section.

SECTION 3. This act shall take effect and be in force from and after July 1, 2024.