,,ii  #aahth ,,congress  #ast ,session  
,s4 #bdfd  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,july #be1     
#bjbc,mrs4 ,shaheen 7for herself and    
,mrs4 ,britt7 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 
with respect to diagnostic and          
supplemental breast examinations4  #a4  
,short title ,this ,act may be cited as 
the ,access to ,breast ,cancer          
,diagnosis ,act of #bjbc4  #b4          
,requiring diagnostic and supplemental  
breast examinations to be covered with  
no cost-sharing requirements  7a7 ,in   
general ,subpart ,,ii of part ,a of     
title ,,xxvii of the ,public ,health    
,service ,act 7#db ,u4,s4,c4 #cjj;gg-#aa

 et seq47 is amended by adding at the   
end the following new section3  #bgcj4  
,diagnostic and supplemental breast     
examinations  7a7 ,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  
diagnostic and supplemental breast      
examinations furnished to an individual 
enrolled under such plan or such        
coverage1 such plan or coverage shall   
not impose any cost-sharing requirements
 for these benefits4  7b7 ,construction 
,nothing in this section shall be       
construed-- 7#a7 to prohibit a group    
health plan or health insurance issuer  
from requiring timely prior             
authorization or imposing other         
appropriate utilization controls in     
approving coverage for any diagnostic   
and supplemental breast examination2 or 
7#b7 to supersede a ,state law that     
provides greater protections with       
respect to the coverage of diagnostic   

and supplemental breast examinations    
than is provided under this section4    
7c7 ,definitions ,in this section3 7#a7 
,cost-sharing requirements ,the term    
cost-sharing requirements means a       
deductible1 coinsurance1 copayment1 and 
any maximum limitation on the           
application of such a deductible1       
coinsurance1 copayment or similar       
out-of-pocket expense4  7#b7 ,diagnostic
 breast examination ,the term diagnostic
 breast examination means a medically   
necessary and appropriate 7in accordance
 with ,national ,comprehensive ,cancer  
,network ,guidelines7 examination of the
 breast 7including1 but not limited to  
such an examination using diagnostic    
mammography1 breast magnetic resonance  
imaging1 or breast ultrasound7 that is--
 7,a7 used to evaluate an abnormality   
seen or suspected from a screening      
examination for breast cancer2 or  7,b7 
used to evaluate an abnormality detected
 by another means of examination4  7#c7 
,supplemental breast examinations ,the  

term supplemental breast examination    
means a medically necessary and         
appropriate 7in accordance with         
,national ,comprehensive ,cancer        
,network ,guidelines7 examination of the
 breast 7including1 but not limited to  
such an examination using breast        
magnetic resonance imaging or breast    
ultrasound7 that is-- 7,a7 used to      
screen for breast cancer when there is  
no abnormality seen or suspected2 and   
7,b7 furnished based on personal or     
family medical history or additional    
factors that may increase the           
individual's risk of breast cancer4  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 ,act2 and  7#b7 by    
adding at the end the following new     
clause3  7v7 ,section #bgcj 7relating to

 coverage for diagnostic and            
supplemental breast examinations74  4   
7c7 ,application to high deductible     
health plans with health savings account
 eligibility ,section #bbc7;c77#b7 of   
the ,internal ,revenue ,code of #aihf is
 amended by adding at the end the       
following3  7,h7 ,safe harbor for       
absence of deductible for diagnostic and
 supplemental breast examinations ,in   
the case of plan years beginning on or  
after ,january #a1 #bjbd1 a plan shall  
not fail to be treated as a high        
deductible health plan by reason of     
failing to have a deductible for        
diagnostic and supplemental breast      
examinations4  4  7d7 ,effective date   
,the amendments made by this section    
shall apply with respect to plan years  
beginning on or after ,january #a1      
#bjbd4