*beginning January 1, 2022, as existing insurance policies expire, new versions will be required to cover breast MRIs and ultrasounds for women insured under Pennsylvania law with high-risk conditions for breast cancer.
GOVERNOR WOLF SIGNS SB 595 FOR INSURANCE COVERAGE OF BREAST MRI, ULTRASOUND
FOR IMMEDIATE RELEASE
JULY 2, 2020
HARRISBURG – Pennsylvania Governor Tom Wolf signed the PA Breast Cancer Coalition’s latest breast cancer screening legislation for women across the state. Senate Bill 595, sponsored by Sen. Bob Mensch (R-24), requires insurers to cover breast MRIs and ultrasounds for women with very dense breasts and other high-risk factors for breast cancer.
“This is a great victory for the women of Pennsylvania and the families that love them. We salute Governor 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,” 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 that women need. Thank you, chief sponsor Sen. Bob Mensch for your dedication to this bill and thank you, Governor Wolf, for taking this historic action!”
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. Breast MRIs and ultrasounds are often necessary to provide accuracy, but some insurers did not cover those screenings. Senate Bill 595 requires insurance coverage of MRIs and ultrasounds for women with:
- Personal history of breast cancer
- Family history of breast cancer
- Genetic predisposition
- Extremely dense breast tissue
- Heterogeneously dense breast tissue and one other high-risk factor
“Medical advancements have brought greater peace of mind to many women suffering from breast cancer,” said Sen. Bob Mensch. “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. Solutions are within our grasp, and Senate Bill 595 makes these potentials an even greater reality.”
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.