Governer Tom Wolf Signs Senate Bill 595 Requiring Insurance Coverage of Breast MRI, Ultrasound

Governer Tom Wolf Signs Senate Bill 595 Requiring Insurance Coverage of Breast MRI, Ultrasound

ACT 52/SB 595 to cover supplemental screenings for women with dense breasts, high-risk factors

Pennsylvania Governor Tom Wolf signed the PA Breast Cancer Coalition’s life-saving 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 victory for the women of Pennsylvania and the families who love them. We are grateful to Governor Wolf for signing Senate Bill 595, legislation we know will save women’s lives by providing affordable access to the early detection of breast cancer,” said PBCC President and Founder Pat Halpin-Murphy. “Thanks to Governor Wolf, not only are we the first state in the nation to cover 3D mammograms at no cost to women, we are now on the forefront of states across the country in offering women insurance coverage for MRIs and ultrasounds they need to survive. Thank you, chief sponsor Sen. Bob Mensch for your dedication to this bill and thank you, Governor, for taking this historic action!”

For women with dense breasts and/or other high-risk factors such as a personal history of breast cancer, a family history or a genetic predisposition, a mammogram may not be enough to detect a lump or irregularity in the breast. Screenings like breast MRIs and ultrasounds are often necessary to provide accuracy, but some insurers do not currently cover those screenings. SB 595 requires insurance coverage of MRIs and ultrasounds for women with:

  • Extremely dense breast tissue
  • High-risk factors for breast cancer
  • 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 new law, the patient may be responsible for costs such as co-pays, co-insurance and/or deductibles based on the individual’s health insurance policy regulated under Pennsylvania law. Each patient is advised to contact her insurer to determine what costs the insured would be responsible for prior to receiving the MRI and/or ultrasound.