,i #aagth ,,congress #b;d ,session ,h4 ,r4 #ieje ,,in ,,the ,,house ,,of ,,representatives ,december #ac1 #bjbb,ms4 ,de,lauro 7for herself1 ,mr4 ,fitzpatrick1 ,ms4 ,kaptur1 ,mr4 ,courtney1 ,mr4 ,bishop of ,georgia1 ,ms4 ,schakowsky1 ,mr4 ,trone1 ,ms4 ,jackson ,lee1 and ,mr4 ,kahele7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committees on ,ways and ,means1 ,armed ,services1 and ,veterans' ,affairs1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to provide for health coverage with no cost-sharing for additional breast screenings for certain individuals at greater risk for breast cancer4 #a4 ,short title ,this ,act may be cited as the ,find ,it ,early ,act4 #b4 ,coverage with no cost-sharing for additional breast screenings for ,certain ,individuals at ,greater ,risk for ,breast ,cancer 7a7 ,coverage under group health plans and group and individual health insurance coverage 7#a7 ,in general ,section #bgac7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ac7;a77 is amended-- 7,a7 in paragraph 7#b71 by striking at the end and2 7,b7 in paragraph 7#c71 by striking at the end the period and inserting a semicolon2 7,c7 in paragraph 7#d71 by striking at the end the period and inserting 2 and2 7,d7 by striking 7#e7 for the purposes of this ,act1 and inserting3 ,for the purposes of this ,act1 subject to paragraph 7#e7 2 and 7,e7 by inserting after paragraph 7#d7 the following3 7#e7 for plan years beginning on or after ,january #a1 #bjbc1 in addition to any items or services otherwise described in this subsection-- 7,a7 with respect to an individual who is at increased risk of breast cancer 7as determined in accordance with the most recent applicable ,american ,college of ,radiology ,appropriateness ,criteria or the most recent applicable guidelines of the ,national ,comprehensive ,cancer ,network7 or with heterogeneously or extremely dense breast tissue 7as defined by the ,breast ,imaging ,reporting and ,data ,system established by the ,american ,college of ,radiology71 screening and diagnostic imaging 7with no limitation applied on frequency7 for the detection of breast cancer1 including #b;,d or #c;,d mammograms1 breast ultrasounds1 breast magnetic resonance imaging1 or other technologies 7as determined in accordance with such applicable criteria or guidelines72 and 7,b7 with respect to an individual who is not described in subparagraph 7,a7 and who is determined by a health care provider 7in accordance with such most recent applicable criteria or guidelines7 to require screening or diagnostic breast imaging by reason of factors1 including age1 race1 ethnicity1 or personal or family medical history1 screening and diagnostic imaging 7with no limitation applied on frequency7 for the detection of breast cancer1 including #b;,d or #c;,d mammograms1 breast ultrasounds1 breast magnetic resonance imaging1 or other technologies 7as determined in accordance with such applicable criteria or guidelines74 4 7#b7 ,application to grandfathered plans ,notwithstanding section #abea of the ,patient ,protection and ,affordable ,care ,act1 the provisions of paragraph 7#e7 of section #bgac7;a7 of the ,public ,health ,service ,act1 as added by paragraph 7#a77;,e71 shall apply to grandfathered health plans described in such section #abea for plan years beginning on or after ,january #a1 #bjbc4 7b7 ,coverage under ,medicare 7#a7 ,in general ,section #ahfa7;ddd77#a77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciex7ddd77#a77;,b77 is amended-- 7,a7 by striking 7,b7 recommended and inserting 7,b77i7 recommended2 7,b7 by striking ,task ,force2 and and inserting ,task ,force2 or2 and 7,c7 by adding at the end the following new clause3 7ii7 beginning on ,january #a1 #bjbc1 in addition to any other items or services described in this subsection-- 7,i7 with respect to an individual who is at increased risk of breast cancer 7as determined in accordance with the most recent applicable ,american ,college of ,radiology ,appropriateness ,criteria or the most recent applicable guidelines of the ,national ,comprehensive ,cancer ,network7 or with heterogeneously or extremely dense breast tissue 7as defined by the ,breast ,imaging ,reporting and ,data ,system established by the ,american ,college of ,radiology71 screening and diagnostic imaging 7with no limitation applied on frequency7 for the detection of breast cancer1 including #b;,d or #c;,d mammograms1 breast ultrasounds1 breast magnetic resonance imaging1 or other technologies 7as determined in accordance with such applicable criteria or guidelines72 and 7,,ii7 with respect to an individual who is not described in subclause 7,i7 and who is determined by a health care provider 7in accordance with such most recent applicable criteria or guidelines7 to require screening or diagnostic breast imaging by reason of factors1 including age1 race1 ethnicity1 or personal or family medical history1 screening and diagnostic imaging 7with no limitation applied on frequency7 for the detection of breast cancer1 including #b;,d or #c;,d mammograms1 breast ultrasounds1 breast magnetic resonance imaging1 or other technologies 7as determined in accordance with such applicable criteria or guidelines72 and 4 7#b7 ,application of no cost-sharing under ,medicare ,advantage plans ,section #aheb7;a77#a77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bb7;a77#a77;,b77 is amended-- 7,a7 in clause 7iv7-- 7i7 by redesignating subclause 7,,viii7 as subclause 7,,ix72 and 7ii7 inserting after subclause 7,,vii7 the following3 7,,viii7 ,beginning on ,january #a1 #bjbc1 screening and diagnostic imaging and other technologies described in subclause 7,i7 or 7,,ii7 of section #ahfa7;ddd77#a77;,b77ii7 furnished to an individual described in such subclause 7,i7 or 7,,ii71 respectively4 2 and 7,b7 in clause 7v71 by striking and 7,,vi7 and inserting 7,,vi71 and 7,,viii74 7c7 ,coverage under ,medicaid 7#a7 ,in general ,section #aije7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77 is amended-- 7,a7 in paragraph 7#d7-- 7i7 by striking 2 and 7,d7 and inserting 2 7,d72 7ii7 by striking 2 and 7,e7 and inserting 2 7,e72 7iii7 by striking 2 and 7,f7 and inserting 2 7,f72 and 7iv7 by inserting before the semicolon at the end the following3 2 and 7,g77i7 with respect to an individual who is at increased risk of breast cancer 7as determined in accordance with the most recent applicable ,american ,college of ,radiology ,appropriateness ,criteria or the most recent applicable guidelines of the ,national ,comprehensive ,cancer ,network7 or with heterogeneously or extremely dense breast tissue 7as defined by the ,breast ,imaging ,reporting and ,data ,system established by the ,american ,college of ,radiology71 in addition to any other item or service described in this subsection1 screening and diagnostic imaging 7with no limitation applied on frequency7 for the detection of breast cancer1 including #b;,d or #c;,d mammograms1 breast ultrasounds1 breast magnetic resonance imaging1 or other technologies 7as determined in accordance with such applicable criteria or guidelines72 and 7ii7 with respect to an individual who is not described in clause 7i7 and who is determined by a health care provider 7in accordance with such most recent applicable criteria or guidelines7 to require screening or diagnostic breast imaging by reason of factors1 including age1 race1 ethnicity1 or personal or family medical history1 screening and diagnostic imaging 7with no limitation applied on frequency7 for the detection of breast cancer1 including #b;,d or #c;,d mammograms1 breast ultrasounds1 breast magnetic resonance imaging1 or other technologies 7as determined in accordance with such applicable criteria or guidelines72 and 7,b7 in paragraph 7#ac71 in the matter preceding subparagraph 7,a71 by inserting 7other than an item or service for which medical assistance is provided pursuant to paragraph 7#d77;,g77 after services4 7#b7 ,no cost-sharing for certain ,breast cancer screening and diagnostic imaging 7,a7 ,in general ,subsections 7a77#b7 and 7b77#b7 of section #aiaf of the ,social ,security ,act 7#db ,u4,s4,c4 #acifo7a77#b77;,d77 are each amended-- 7i7 in the last subparagraph1 by striking at the end 2 and and inserting 1 or2 and 7ii7 by adding at the end the following subparagraph3 7,k7 with respect to an individual described in clause 7i7 or 7ii7 of section #aije7;a77#d77;,g71 screening and diagnostic imaging and other technologies described in such clause 7i7 or 7ii71 respectively2 and 4 7,b7 ,application to alternative cost-sharing ,section #aiaf;,a7b77#c77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifo-#a7;b77#c77;,b77 is amended by adding at the end the following new clause3 7xv7 ,with respect to an individual described in clause 7i7 or 7ii7 of section #aije7;a77#d77;,g71 screening and diagnostic imaging and other technologies described in such clause 7i7 or 7ii71 respectively4 4 7#c7 ,inclusion in benchmark coverage ,section #aicg7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifu-#g7;b77 is amended by adding at the end the following new paragraph3 7#i7 ,coverage of certain breast cancer screening and diagnostic imaging for certain individuals ,notwithstanding the previous provisions of this section1 a ,state may not provide for medical assistance through enrollment of an individual with benchmark coverage or benchmark-equivalent coverage under this section unless such coverage includes medical assistance1 with respect to an individual described in clause 7i7 or 7ii7 of section #aije7;a77#d77;,g71 for screening and diagnostic imaging and other technologies described in such clause 7i7 or 7ii71 respectively4 4 7#d7 ,effective date 7,a7 ,in general ,except as provided in subparagraph 7,b71 the amendments made by this subsection shall take effect on ,january #a1 #bjbc4 7,b7 ,delay permitted if ,state legislation required ,in the case of a ,state plan approved under title ,,xix of the ,social ,security ,act which the ,secretary of ,health and ,human ,services determines requires ,state legislation 7other than legislation appropriating funds7 in order for the plan to meet the additional requirements imposed by this section1 the ,state plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of the failure of the plan to meet such additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the ,state legislature that ends after the #a-year period beginning with the date of the enactment of this section4 ,for purposes of the preceding sentence1 in the case of a ,state that has a #b-year legislative session1 each year of the session is deemed to be a separate regular session of the ,state legislature4 7d7 ,coverage and elimination of cost-,sharing under ,,tricare 7#a7 ,coverage ,title #aj1 ,united ,states ,code1 is amended-- 7,a7 in section #ajgd;d7a71 by adding at the end the following new paragraph3 7#c7 ,any member or former member of the uniformed services who is entitled to medical care under section #ajgd or #ajgd;a of this title and is an individual described in subparagraph 7,b7 of section #ajgi7;a77#bj7 of this title shall also be entitled to the items and services described in subparagraph 7,a7 of such section 7subject to the same limitations specified in such subparagraph71 as part of such medical care4 2 and 7,b7 in section #ajgi7;a71 by adding at the end the following new paragraph3 7#bj7 7,a7 ,screening and diagnostic imaging 7with no limitation applied on frequency7 for the detection of breast cancer1 including #b;,d or #c;,d mammograms1 breast ultrasounds1 breast magnetic resonance imaging1 or other technologies 7as determined in accordance with the most recent applicable criteria or guidelines described in subparagraph 7,b771 shall be provided if the patient is an individual described in subparagraph 7,b74 7,b7 ,an individual described in this subparagraph is-- 7i7 an individual who is at increased risk of breast cancer 7as determined in accordance with the most recent applicable ,american ,college of ,radiology ,appropriateness ,criteria or the most recent applicable guidelines of the ,national ,comprehensive ,cancer ,network7 or with heterogeneously or extremely dense breast tissue 7as defined by the ,breast ,imaging ,reporting and ,data ,system established by the ,american ,college of ,radiology72 or 7ii7 an individual who is not described in clause 7i7 and who is determined by a health care provider 7in accordance with such most recent applicable criteria or guidelines7 to require screening or diagnostic breast imaging by reason of factors including age1 race1 ethnicity1 or personal or family medical history4 4 7#b7 ,elimination of cost-sharing ,such title is further amended-- 7,a7 in section #ajge;a1 by adding at the end the following new subsection3 7d7 ,elimination of cost-,sharing for certain breast cancer-,related items and services ,notwithstanding any other provision under this section1 cost-sharing may not be imposed or collected with respect to any beneficiary enrolled in ,,tricare ,prime for any item or service described in subparagraph 7,a7 of section #ajgi7;a77#bj7 of this title provided under ,,tricare ,prime1 in accordance with the limitations specified in such subparagraph1 if the beneficiary is an individual described in subparagraph 7,b7 of such section4 2 7,b7 in section #ajge7;c71 by adding at the end the following new paragraph3 7#d7 ,notwithstanding any other provision under this section1 cost-sharing may not be imposed or collected with respect to any beneficiary enrolled in ,,tricare ,select for any item or service described in subparagraph 7,a7 of section #ajgi7;a77#bj7 of this title provided under ,,tricare ,select1 in accordance with the limitations specified in such subparagraph1 if the beneficiary is an individual described in subparagraph 7,b7 of such section4 2 and 7,c7 in section #ajhf7;d77#c7-- 7i7 by redesignating subparagraph 7,c7 as subparagraph 7,d72 and 7ii7 by inserting after subparagraph 7,b7 the following new subparagraph3 7,c7 ,notwithstanding any other provision under this section1 cost-sharing may not be imposed or collected under subsection 7a7 with respect to any individual described in subparagraph 7,b7 of section #ajgi7;a77#bj7 of this title for an item or service described in subparagraph 7,a7 of such section and provided in accordance with the limitations specified in such subparagraph4 4 7#c7 ,effective date ,the amendments made by this subsection shall take effect on ,january #a1 #bjbc4 7e7 ,coverage and elimination of cost-,sharing with respect to veterans 7#a7 ,coverage and elimination of cost-sharing ,chapter #ag of title #ch1 ,united ,states ,code1 is amended by inserting after section #agbj;,j the following new section 7and conforming the table of sections at the beginning of such chapter accordingly73 #agbj,k4 ,breast screenings for certain individuals at increased risk for breast cancer 7a7 ,coverage of items and services 7#a7 ,coverage ,the ,secretary shall furnish to a veteran described in paragraph 7#b7 screening and diagnostic imaging 7with no limitation applied on frequency7 for the detection of breast cancer1 including #b;,d or #c;,d mammograms1 breast ultrasounds1 breast magnetic resonance imaging1 or other technologies 7as determined in accordance with the most recent applicable criteria or guidelines described in such paragraph7 pursuant to this section4 7#b7 ,eligibility ,a veteran described in this subparagraph is-- 7,a7 a veteran who is at increased risk of breast cancer 7as determined in accordance with the most recent applicable ,american ,college of ,radiology ,appropriateness ,criteria or the most recent applicable guidelines of the ,national ,comprehensive ,cancer ,network7 or with heterogeneously or extremely dense breast tissue 7as defined by the ,breast ,imaging ,reporting and ,data ,system established by the ,american ,college of ,radiology71 without regard to whether the veteran is enrolled in the system of annual patient enrollment established under section #agje7;a7 of this title2 or 7,b7 a veteran who is not described in subparagraph 7,a7 and who is determined by a health care provider 7in accordance with such most recent applicable criteria or guidelines7 to require screening or diagnostic breast imaging by reason of factors including age1 race1 ethnicity1 or personal or family medical history1 without regard to whether the veteran is enrolled in the system of annual patient enrollment established under section #agje7;a7 of this title4 7b7 ,prohibition on cost-,sharing ,notwithstanding subsections 7f7 and 7g7 of section #agaj and section #agbb;,a of this title1 the ,secretary may not require any veteran described in paragraph 7#b7 of subsection 7a7 to make any copayment for1 or charge the veteran for any other cost of1 the receipt of any item or service furnished pursuant to paragraph 7#a7 of such subsection4 4 7#b7 ,effective date ,the amendments made by this subsection shall take effect on ,january #a1 #bjbc4