PLEASE NOTE: Legislative Information cannot perform research, provide legal advice, or interpret Maine law. For legal assistance, please contact a qualified attorney.
An Act Relating to Insurance Coverage for Screening Mammograms
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 24 MRSA §2320-A, sub-§1, as enacted by PL 1989, c. 875, Pt. I, §2, is amended to read:
 
1. Definition.   For purposes of this section, "screening mammogram" means a radiologic procedure that is provided to an asymptomatic woman for the purpose of early detection of breast cancer and that consists of 2 radiographic views per breast or, beginning January 1, 2020, 3-dimensional tomosynthesis.
Sec. 2. 24-A MRSA §2745-A, sub-§1, as amended by PL 2007, c. 153, §1 and affected by §5, is further amended to read:
 
1. Definition.   For purposes of this section, "screening mammogram" means a radiologic procedure that is provided to an asymptomatic woman for the purpose of early detection of breast cancer and that consists of 2 radiographic views per breast or, beginning January 1, 2020, 3-dimensional tomosynthesis. A screening mammogram also includes an additional radiologic procedure recommended by a provider when the results of an initial radiologic procedure are not definitive.
Sec. 3. 24-A MRSA §2837-A, sub-§1, as amended by PL 2007, c. 153, §2 and affected by §5, is further amended to read:
 
1. Definition.   For purposes of this section, "screening mammogram" means a radiologic procedure that is provided to an asymptomatic woman for the purpose of early detection of breast cancer and that consists of 2 radiographic views per breast or, beginning January 1, 2020, 3-dimensional tomosynthesis. A screening mammogram also includes an additional radiologic procedure recommended by a provider when the results of an initial radiologic procedure are not definitive.
Sec. 4. 24-A MRSA §4237-A, sub-§1, as amended by PL 2007, c. 153, §3 and affected by §5, is further amended to read:
 
1. Definition.   For purposes of this section, "screening mammogram" means a radiologic procedure that is provided to an asymptomatic woman for the purpose of early detection of breast cancer and that consists of 2 radiographic views per breast or, beginning January 1, 2020, 3-dimensional tomosynthesis. A screening mammogram also includes an additional radiologic procedure recommended by a provider when the results of an initial radiologic procedure are not definitive.
Sec. 5. Reimbursement. Beginning January 1, 2020, health insurance reimbursement pursuant to the Maine Revised Statutes, Title 24, section 2320-A or Title 24-A, section 2745-A, 2837-A or 4237-A must reflect the resource costs specific to each modality, including any increased resource cost of breast tomosynthesis.
 
SUMMARY
This bill amends the definition of "screening mammogram" to include 3-dimensional tomosynthesis for purposes of required health insurance coverage and reimbursement by individual plans, group plans, health maintenance organizations and nonprofit hospital and medical service organizations.