Legislation introduced in the U.S. Congress, The Find it Early Act, would require all private payers - along with traditional Medicare and Medicare Advantage plans, Medicaid and TRICARE - to cover any supplemental breast imaging services, beyond screening mammograms. This would include supplemental imaging exams as diagnostic mammograms, breast ultrasound and breast MRI, with no patient out-of-pocket costs. Such costs can include the payer's requirements for co-payment and deductible payments from the patient.
Support for the legislation has been expressed by DenseBreast-info, the Brem Foundation to Defeat Breast Cancer and the Susan G. Komen organization. It is too early to tell if the support for this legislation will influence Congress to pass this initiative.
The Congressional patrons of the legislation propose coverage beyond screening mammograms based on their assumption that out-of-pocket costs for screening mammograms are not required for screening patients. But the recent decision by a Federal District Court judge in Texas now raises questions about whether certain mammography screening services will remain available to patients without those costs also.
The Texas Federal Court decision is being appealed, but one wonders whether Congress may also need to enact a new no out-of-pocket mandate for screening mammography coverage also.