,,ii  #aafth ,,congress  #b;d ,session  
,s4 #cbaf  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,january #af1  
#bjbj,mr4 ,blunt 7for himself and ,mrs4 
,shaheen7 introduced the following bill2
 which was read twice and referred to   
the ,committee on ,health1 ,education1  
,labor1 and ,pensions  ,a ,,bill  ,to   
amend title ,,xxvii of the ,public      
,health ,service ,act to prohibit group 
health plans and health insurance       
issuers offering group or individual    
health insurance coverage from imposing 
cost-sharing requirements or treatment  
limitations with respect to diagnostic  
examinations for breast cancer that are 
less favorable than such requirements   
with respect to screening examinations  
for breast cancer4  #a4 ,short title    
,this ,act may be cited as the ,access  
to ,breast ,cancer ,diagnosis ,act of   
#bjbj4  #b4 ,requiring parity in        
cost-sharing and treatment limitations  
with respect to diagnostic and screening
 examinations for breast cancer  7a7 ,in

 general ,section #bgai;,a of the       
,public ,health ,service ,act 7#db      
,u4,s4,c4 #cjj;gg-#ai;a7 is amended by  
adding at the end the following new     
subsection3  7e7 ,diagnostic and        
screening examinations for breast cancer
 parity  7#a7 ,in general ,in the case  
of a group health plan1 or a health     
insurance issuer offering group or      
individual health insurance coverage1   
that provides benefits with respect to a
 diagnostic examination for breast      
cancer furnished to an individual       
enrolled under such plan or such        
coverage1 such plan or such coverage    
shall ensure that--  7,a7 the           
cost-sharing requirements applicable to 
such examination for such individual are
 no less favorable than such            
requirements applicable to a screening  
examination for breast cancer for such  
individual2 and  7,b7 the treatment     
limitations applicable to such          
diagnostic examination for breast cancer
 for such individual are no less        

favorable than such limitations         
applicable to a screening examinations  
for breast cancer for such individual4  
7#b7 ,restriction on certain changes ,a 
group health plan or health insurance   
issuer may not1 for the sole purpose of 
complying with paragraph 7#a71 increase 
cost-sharing requirements with respect  
to screening examinations for breast    
cancer4  7#c7 ,construction ,nothing in 
this subsection shall be construed--    
7,a7 to require the use of diagnostic   
examinations for breast cancer as a     
replacement for screening examinations  
for breast cancer2  7,b7 to prohibit a  
group health plan or health insurance   
issuers from requiring prior            
authorization or imposing other         
appropriate utilization controls in     
approving coverage for any screening or 
diagnostic imaging2 or  7,c7 to         
supersede a ,state law that provides    
greater protections with respect to the 
coverage of diagnostic examinations for 
breast cancer than is provided under    

this subsection4  7#d7 ,definitions ,in 
this subsection3 7,a7 ,cost-sharing     
requirement ,the term cost-sharing      
requirement includes a deductible1      
coinsurance1 copayment1 and any maximum 
limitation on the application of such a 
deductible1 coinsurance1 copayment1 or  
similar out-of-pocket expense4  7,b7    
,diagnostic examination for breast      
cancer ,the term diagnostic examination 
for breast cancer means a medically     
necessary and appropriate 7as determined
 by the health care professional        
treating the individual7 examination for
 breast cancer to evaluate an           
abnormality in the breast that is--  7i7
 seen or suspected from a screening     
examination for breast cancer2  7ii7    
detected by another means of            
examination2 or  7iii7 suspected based  
on the medical history or family medical
 history of the individual4  7,c7       
,examination for breast cancer ,the term
 examination for breast cancer includes 
such an examination using breast        

ultrasound1 breast magnetic resonance   
imaging1 or mammography4  7,d7          
,treatment limitation ,the term         
treatment limitation includes limits on 
the frequency of treatment1 number of   
visits1 days of coverage1 or other      
similar limits on the scope or duration 
of treatment4  4  7b7 ,application to   
grandfathered health plans ,section     
#abea7;a77#d77;,a7 of the ,patient      
,protection and ,affordable ,care ,act  
7#db ,u4,s4,c4 #ahjaa7;a77#d77;,a77 is  
amended--  7#a7 by striking title and   
inserting title1 or as added after the  
date of the enactment of this ,act72 and
  7#b7 by adding at the end the         
following new clause3  7v7 ,section     
#bgai;,a7e7 7relating to parity for     
diagnostic and screening examinations   
for breast cancer74  4  7c7 ,effective  
date ,the amendments made by this       
section shall apply with respect to plan
 years beginning on or after ,january   
#a1 #bjba4