Pennsylvania Gov. Josh Shapiro signed legislation May 1 that will require all payers operating in the state to eliminate any out-of-pocket costs for annual breast cancer screenings and genetic testing for high risk individuals.
Specifically, the new legislation requires coverage for genetic counseling and testing for hereditary breast, ovarian, prostate and other cancer syndromes, along with yearly supplemental breast MRIs or ultrasounds for women with a high risk of breast cancer.
High-risk conditions include those that have dense breast tissue, a personal or family history of breast cancer, a genetic predisposition to cancer, and previous radiation therapy.
Pennsylvania has required payers to cover the cost of breast cancer MRIs and ultrasounds since 2020, and the new legislation expands that requirement to copays and deductibles.