32:1 New Section; Women's Health Care; Coverage for Diagnostic and Supplemental Breast Examinations. Amend RSA 417-D by inserting after section 2-b the following new section:

417-D:2-c Coverage for Diagnostic and Supplemental Breast Examinations.

I. No group health plan, or a health insurance issuer offering group or individual health insurance coverage, that provides benefits with respect to screening and diagnostic and supplemental breast examinations furnished to an individual enrolled under such plan or coverage, shall impose any cost-sharing requirements for such services.

II. For a health care contract that meets the definition of a "high deductible plan" set forth in 26 U.S.C. section 223(c)(2), this requirement shall apply only after the enrollee has satisfied the minimum deductible under section 223 for the year, except with respect to items or services that are preventive care pursuant to section 223(c)(2)(C) of the federal Internal Revenue Code, in which case paragraph I shall apply regardless of whether the minimum deductible under section 223 has been satisfied.

III. In this section:

(a) "Cost-sharing requirements" mean a deductible, coinsurance, copayment, and any maximum limitation on the application of such a deductible, coinsurance, copayment or similar out-of-pocket expense.

(b) "Diagnostic breast examination" means a medically necessary and appropriate examination of the breast, including such an examination using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound, that is:

(1) Used to evaluate an abnormality seen or suspected from a screening examination for breast cancer; or

(2) Used to evaluate an abnormality detected by another means of examination.

(c) "Supplemental breast examination" means a medically necessary and appropriate examination of the breast, including such an examination using breast magnetic resonance imaging, or breast ultrasound, that is:

(1) Used to screen for breast cancer when there is no abnormality seen or suspected; and

(2) Based on personal or family medical history, or additional factors that may increase the individual's risk of breast cancer.

32:2 Effective Date. This act shall take effect January 1, 2025.

Approved: May 31, 2024

Effective Date: January 01, 2025

32:1 New Section; Women's Health Care; Coverage for Diagnostic and Supplemental Breast Examinations. Amend RSA 417-D by inserting after section 2-b the following new section:

417-D:2-c Coverage for Diagnostic and Supplemental Breast Examinations.

I. No group health plan, or a health insurance issuer offering group or individual health insurance coverage, that provides benefits with respect to screening and diagnostic and supplemental breast examinations furnished to an individual enrolled under such plan or coverage, shall impose any cost-sharing requirements for such services.

II. For a health care contract that meets the definition of a "high deductible plan" set forth in 26 U.S.C. section 223(c)(2), this requirement shall apply only after the enrollee has satisfied the minimum deductible under section 223 for the year, except with respect to items or services that are preventive care pursuant to section 223(c)(2)(C) of the federal Internal Revenue Code, in which case paragraph I shall apply regardless of whether the minimum deductible under section 223 has been satisfied.

III. In this section:

(a) "Cost-sharing requirements" mean a deductible, coinsurance, copayment, and any maximum limitation on the application of such a deductible, coinsurance, copayment or similar out-of-pocket expense.

(b) "Diagnostic breast examination" means a medically necessary and appropriate examination of the breast, including such an examination using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound, that is:

(1) Used to evaluate an abnormality seen or suspected from a screening examination for breast cancer; or

(2) Used to evaluate an abnormality detected by another means of examination.

(c) "Supplemental breast examination" means a medically necessary and appropriate examination of the breast, including such an examination using breast magnetic resonance imaging, or breast ultrasound, that is:

(1) Used to screen for breast cancer when there is no abnormality seen or suspected; and

(2) Based on personal or family medical history, or additional factors that may increase the individual's risk of breast cancer.

32:2 Effective Date. This act shall take effect January 1, 2025.

Approved: May 31, 2024

Effective Date: January 01, 2025