HARRISBURG, PA — Insurers must cover ultrasounds and MRIs for women with dense breast tissue, now that Senate Bill 595 is law. Sponsored by Sen. Bob Mensch (R-24), the bill became law with the signature of Gov. Tom Wolf on July 2. The PA Breast Cancer Coalition supported the legislation that will help women at high risk of breast cancer get the level of prevented screenings they need.
"This is a great victory for the women of Pennsylvania and the families that love them," said PBCC President and Founder Pat Halpin-Murphy. "We are now on the forefront of states across the country requiring insurers to cover breast MRIs and ultrasounds for women that need them. Thank you, chief sponsor Sen. Bob Mensch for your dedication to this bill."
"We salute Gov. Tom Wolf for signing SB 595, legislation we know will save women's lives or greatly improve women's lives by providing affordable access to the early detection of breast cancer," Halpin-Murphy said in a July 2 media release.
SB 595 was one of 19 pieces of legislation made law on Thursday, July 2.
For women with very dense breasts and/or other high-risk factors, a mammogram may not be enough to detect a lump or irregularity in the breast, according to the PA Breast Cancer Coalition. Breast MRIs and ultrasounds are often necessary to provide accuracy, but some insurers did not cover those screenings. SB 595 requires insurance coverage of MRIs and ultrasounds for women with:
- Extremely dense breast tissue,
- High-risk factors for breast cancer such as a personal history of breast cancer, a family history of breast cancer or a genetic predisposition,
- Heterogeneously dense breast tissue and one other high-risk factor.
Mensch said, "Medical advancements have brought greater peace of mind to many women suffering from breast cancer. Over the years, insurance coverages have been working to keep pace with these advancements to ensure the best possible outcomes for breast cancer victims. Senate Bill 595 brings the medical community and the insurance community even closer together to provide better coverage, and to hopefully provide greater health, comfort and peace of mind to those suffering with this disease."
Mensch insisted, "Solutions are within our grasp, and Senate Bill 595 makes these potentials an even greater reality." He explained that under the law, the patient may be responsible for normal costs such as co-pays, co-insurance and/or deductibles based on the individual's health insurance policy.
The new law applies only to insurance companies that issue policies covered under Pennsylvania law. Implementation dates vary depending upon the patient's particular insurance plan.
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