Access to Breast Cancer Diagnosis Act of 2025

Today's wording of each part of the law, with what would be struck out and added. Each change also gives the bill's own instruction, word for word.

1. 42 U.S.C. 300gg-11added 2730by H.R. 3037 Sec. 2(a)

   2730 Diagnostic and supplemental breast examinations.—(a) In general.— In the case of a group health plan, or a health insurance issuer offering group or individual health insurance coverage, that provides benefits with respect to diagnostic and supplemental breast examinations furnished to an individual enrolled under such plan or such coverage, such plan or coverage shall not impose any cost-sharing requirements for these benefits.(b) Construction.— Nothing in this section shall be construed—(1) 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 examination; or(2) 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 section.(c) Definitions.— In this section:(1) Cost-sharing requirements.— The term cost-sharing requirements means a deductible, coinsurance, copayment, and any maximum limitation on the application of such a deductible, coinsurance, copayment or similar out-of-pocket expense.(2) Diagnostic breast examination.— The term diagnostic breast examination means a medically necessary and appropriate (in accordance with National Comprehensive Cancer Network Guidelines) examination of the breast (including, but not limited to such an examination using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound) that is—(A) used to evaluate an abnormality seen or suspected from a screening examination for breast cancer; or(B) used to evaluate an abnormality detected by another means of examination.(3) Supplemental breast examinations.— The term supplemental breast examination means a medically necessary and appropriate (in accordance with National Comprehensive Cancer Network Guidelines) examination of the breast (including, but not limited to such an examination using breast magnetic resonance imaging or breast ultrasound) that is—(A) used to screen for breast cancer when there is no abnormality seen or suspected; and(B) furnished based on personal or family medical history or additional factors that may increase the individual’s risk of breast cancer.

   The bill says: Subpart II of part A of title XXVII of the Public Health Service Act (42 U.S.C. 300gg–11 et seq.) is amended by adding at the end the following new section:

   Bill text · Current law (42 U.S.C. 300gg-11)

2. 42 U.S.C. 18011(a)(4)(A)changedby H.R. 3037 Sec. 2(b)

   The bill says: by striking "title" and inserting "title, or as added after the date of the enactment of this Act"; and

   Bill text · Current law (42 U.S.C. 18011)

3. 42 U.S.C. 18011(a)(4)(A)added (v)by H.R. 3037 Sec. 2(b)

   (v) Section 2730 (relating to coverage for diagnostic and supplemental breast examinations).

   The bill says: by adding at the end the following new clause:

   Bill text · Current law (42 U.S.C. 18011)

4. 26 U.S.C. 223(c)(2)added (H)by H.R. 3037 Sec. 2(c)

   (H) Safe harbor for absence of deductible for diagnostic and supplemental breast examinations.— In the case of plan years beginning on or after January 1, 2026, 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 examinations.

   The bill says: Section 223(c)(2) of the Internal Revenue Code of 1986 is amended by adding at the end the following:

   Bill text · Current law (26 U.S.C. 223)

From the bill's official text on GovInfo and the U.S. Code, 2024 edition, which may not yet show changes made since.