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HR 3037119th CongressIntroduced
Access to Breast Cancer Diagnosis Act of 2025
Introduced: Oct 29, 2025
Healthcare
Standard Summary
Comprehensive overview in 1-2 paragraphs
This legislation amends the Public Health Service Act to eliminate cost-sharing requirements including deductibles, copays, and coinsurance for diagnostic and supplemental breast examinations under all group and individual health insurance plans, ensuring zero out-of-pocket expenses for critical breast cancer detection services starting in 2026 while permitting prior authorization protocols.
Key Points
- 1Prohibits all health insurance plans from imposing any cost-sharing for diagnostic breast exams evaluating abnormalities detected through screenings or other methods.
- 2Extends coverage to supplemental breast examinations for high-risk individuals without abnormalities based on medical history or risk factors.
- 3Explicitly preserves state laws offering stronger protections and allows utilization management like prior authorization for these services.
Impact Areas
Women requiring breast cancer diagnostic services regardless of insurance typeHealth insurance issuers and employer-sponsored group health plans nationwideMedical facilities providing mammography, MRI, and ultrasound breast examinations
Generated by legislative-analyst-2025 on Nov 3, 2025