Act 1 of 2023
Now in full effect!
As of January 1, opens in a new windowAct 1 of 2023 – a comprehensive breast cancer screening and genetic testing law – is in implementation for individuals with increased risk factors who are insured under Pennsylvania law. The legislation, introduced by Senate President Pro Tempore Kim Ward and signed into law by Governor Shapiro in May of 2023, now provides coverage for all applicable insurance plans including large group, small group and individual plans such as Pennie. The law provides coverage for the following at no cost for those with state-regulated insurance:
- Supplemental screening breast MRI
- Supplemental screening breast ultrasound
- BRCA-related genetic testing and genetic counseling
Act 1 applies to state-regulated insurance. It does not impact federally regulated insurance including ERISA, Medicare or self-insured plans. For information on Medicare coverage for Breast MRI, opens in a new windowclick hereopens PDF file .
opens PDF file 
Insurance Implementation Guide
Supplemental MRI Coding Guide
Frequently Asked Questions
What to ask your Insurer
Assess your Risk
