,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #cbaf  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,janu>y #af1 #bjbj,mr4 
,blunt 7= himself & ,mrs4 ,%ahe57       
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to am5d title ,,xxvii ( !   
,public ,heal? ,s]vice ,act to prohibit 
gr\p heal? plans & heal? insurance      
issu]s (f]+ gr\p or individual heal?    
insurance cov]age f impos+ co/-%>+      
requirem5ts or treatm5t limitations )   
respect to diagno/ic exam9ations = brea/
 canc] t are less favorable ?an su*     
requirem5ts ) respect to scre5+         
exam9ations = brea/ canc]4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,access 
to ,brea/ ,canc] ,diagnosis ,act (      
#bjbj4  #b4 ,requir+ p>ity 9 co/-%>+ &  
treatm5t limitations ) respect to       
diagno/ic & scre5+ exam9ations = brea/  
canc]  7a7 ,9 g5]al ,section #bgai;,a ( 
! ,public ,heal? ,s]vice ,act 7#db      
,u4,s4,c4 #cjj;gg-#ai;a7 is am5d$ by    

add+ at ! end ! foll[+ new subsection3  
7e7 ,diagno/ic & scre5+ exam9ations =   
brea/ canc] p>ity  7#a7 ,9 g5]al ,9 !   
case ( a gr\p heal? plan1 or a heal?    
insurance issu] (f]+ gr\p or individual 
heal? insurance cov]age1 t provides     
b5efits ) respect to a diagno/ic        
exam9ation = brea/ canc] furni%$ to an  
individual enroll$ "u su* plan or su*   
cov]age1 su* plan or su* cov]age %all   
ensure t--  7,a7 ! co/-%>+ requirem5ts  
applicable to su* exam9ation = su*      
individual are no less favorable ?an su*
 requirem5ts applicable to a scre5+     
exam9ation = brea/ canc] = su*          
individual2 &  7,b7 ! treatm5t          
limitations applicable to su* diagno/ic 
exam9ation = brea/ canc] = su*          
individual are no less favorable ?an su*
 limitations applicable to a scre5+     
exam9ations = brea/ canc] = su*         
individual4  7#b7 ,re/riction on c]ta9  
*anges ,a gr\p heal? plan or heal?      
insurance issu] may n1 = ! sole purpose 
( comply+ ) p>agraph 7#a71 increase     

co/-%>+ requirem5ts ) respect to scre5+ 
exam9ations = brea/ canc]4  7#c7        
,con/ruction ,no?+ 9 ?is subsection %all
 be con/ru$-- 7,a7 to require ! use (   
diagno/ic exam9ations = brea/ canc] z a 
replacem5t = scre5+ exam9ations = brea/ 
canc]2  7,b7 to prohibit a gr\p heal?   
plan or heal? insurance issu]s f requir+
 prior au?orization or impos+ o!r       
appropriate utilization controls 9      
approv+ cov]age = any scre5+ or         
diagno/ic imag+2 or  7,c7 to sup]s$e a  
,/ate law t provides great] protections 
) respect to ! cov]age ( diagno/ic      
exam9ations = brea/ canc] ?an is provid$
 "u ?is subsection4  7#d7 ,def9itions ,9
 ?is subsection3 7,a7 ,co/-%>+          
requirem5t ,! t]m co/-%>+ requirem5t    
includes a d$uctible1 co9surance1       
copaym5t1 & any maximum limitation on ! 
application ( su* a d$uctible1          
co9surance1 copaym5t1 or simil>         
out-(-pocket exp5se4  7,b7 ,diagno/ic   
exam9ation = brea/ canc] ,! t]m         
diagno/ic exam9ation = brea/ canc] means

 a m$ically necess>y & appropriate 7z   
det]m9$ by ! heal? c>e pr(essional      
treat+ ! individual7 exam9ation = brea/ 
canc] to evaluate an abnormality 9 !    
brea/ t is--  7i7 se5 or suspect$ f a   
scre5+ exam9ation = brea/ canc]2  7ii7  
detect$ by ano!r means ( exam9ation2 or 
7iii7 suspect$ bas$ on ! m$ical hi/ory  
or family m$ical hi/ory ( ! individual4 
7,c7 ,exam9ation = brea/ canc] ,! t]m   
exam9ation = brea/ canc] includes su* an
 exam9ation us+ brea/ ultras\nd1 brea/  
magnetic resonance imag+1 or            
mammography4  7,d7 ,treatm5t limitation 
,! t]m treatm5t limitation includes     
limits on ! frequ5cy ( treatm5t1 numb] (
 visits1 days ( cov]age1 or o!r simil>  
limits on ! scope or duration (         
treatm5t4  4  7b7 ,application to       
gr&fa!r$ heal? plans ,section           
#abea7;a77#d77;,a7 ( ! ,pati5t          
,protection & ,af=dable ,c>e ,act 7#db  
,u4,s4,c4 #ahjaa7;a77#d77;,a77 is       
am5d$--  7#a7 by /rik+ title & ins]t+   
title1 or z add$ aft] ! date ( !        

enactm5t ( ?is ,act72 &  7#b7 by add+ at
 ! end ! foll[+ new clause3  7v7        
,section #bgai;,a7e7 7relat+ to p>ity = 
diagno/ic & scre5+ exam9ations = brea/  
canc]74  4  7c7 ,effective date ,!      
am5dm5ts made by ?is section %all apply 
) respect to plan ye>s beg9n+ on or aft]
 ,janu>y #a1 #bjba4