Newly introduced state insurance bills to cover expanded breast imaging include the following:
Legislation
New state insurance bills
Latest State Insurance Bills, MAB News
U.S. State Insurance Bills
New bills introduced this week to cover expanded breast imaging include the following:
- Florida H0131
- Florida H0141
- Florida H0187
- Hawaii SB189
- New York S00310
- North Dakota HB1283
- Oklahoma HB1389
Medical Advisory Board
We welcome Dr. Priscilla J. Slanetz to the DBI MAB!
Dr. Slanetz is Professor of Radiology, Vice Chair of Academic Affairs & Faculty Development, Breast Imaging Fellowship Director, and the Associate Program Director of Diagnostic Radiology Residency at the Department of Radiology at Boston University Medical Center. She is on the ACR Board of Chancellors and chairs the Commission on Publications and Lifelong Learning (CoPLL) and is also on the AAR Board. In addition, she is part of the editorial committee for Academic Radiology, AJR, and Radiology, and is the recipient of the 2024 Marie Sklodowska-Curie Award, the highest honor from the American Association for Women in Radiology.
Inform and Insurance Law Maps
NEW! Now that the FDA dense breast reporting standard is in effect, DBI has retired its “State Inform Law Map” (however, the map is still available upon request).
As the next focus is insurance coverage for supplemental screening, DBI has launched a new interactive State Law Insurance Map. The map tracks breast imaging insurance coverage by state, and a corresponding State Law Insurance Table is also available.
Visit the ”Insurance/Inform Laws” tab for individual links to:
World Dense Breast Day SUCCESS, NY insurance law
2024 Success Story
- We had participation from people in 104 (!) countries
- Over 16.8 million people saw/read the posts
- Over 51,200 people interacted with the posts by liking, or sharing
New York State Insurance Law
New York has amended its breast imaging insurance law to require certain insurance policies to allow patients additional screenings for breast cancer when the provider deems such screening is necessary under nationally recognized clinical practice guidelines. Please see DBI’s Insurance/Inform Laws tab for more details.
Alaska insurance law, National density inform
State Insurance Law
Alaska is the latest state to enact a law that requires insurers to cover expanded breast imaging. Visit the DBI Insurance/Inform Laws tab for updated maps and new insurance table.
National Density Inform Standard (finally)
On Tuesday, September 10, the FDA’s requirement to provide patients with one of two standardized letters (“dense” or “not dense”) after their mammograms goes into effect. More information, including how to contact the FDA with questions, is available HERE.
FDA Rule, European Supporter, New Study
FDA Reporting Standard
We are 10 days away from the FDA’s effective date for mandatory density reporting to both patients and referring providers. Please visit DBI’s FDA page which now includes a link to an FDA Compliance Guide (with helpful Q+As). DBI public comments on the September 10th effective date are available HERE.
New European Education Supporter, Albania
We welcome, Iris Allajbeu, MD, PhD, FRCR to the DBI/Europe team! Dr. Allajbeu is Associate Professor of Radiology, Western Balkans University, Tirana, as well as honorary consultant radiologist for the American Hospital in Tirana, International Advisory Board for the Western Balkans University, honorary clinical lecturer and co-lead of Clinical Research, President of ALSOBI and Vice President of the AAR. She is also Senior Clinical Research Associate, Honorary Consultant, Department of Radiology, University of Cambridge Addenbrooke’s Hospital, Cambridge, UK.
Study: Geographic Accessibility
Christensen et al. considered access to MRI and mammography by examining zip codes and a mapping tool that displays the relative socioeconomic conditions of neighborhoods. The study found the average distance to access breast MRI was 23 miles, 22 miles for breast ultrasound, and only 8 miles for mammography.
- Distances were greater in lower socioeconomic areas and rural zip codes.
- Contrast-enhanced mammography can be implemented on most existing digital mammography equipment and could improve access to supplemental screening.
State Insurance Law; AbMRI research
State Insurance Law Amendment
Illinois has amended its insurance law for expanded breast imaging. MBI will now be included (effective 1/1/26), please see DBI’s legislation MAP for details.
Research Analysis
An analysis of “real-world” experience with supplemental abbreviated MRI (AB-MRI) screening in women with dense breasts and average breast cancer risk was conducted by senior author and DBI Advisory Board Member Emily Conant, MD and colleagues. The cancer detection rate for baseline AB-MRI exams was higher than for subsequent exams, however the difference was not significant. [1]
- As expected, for exams with one-year follow-up, the false-positive rate decreased with subsequent exams compared to baseline exams. [2]
- All cancers detected with baseline or subsequent AB-MRI exams were stage 0 or 1, and there were no symptomatic interval cancers.
- The results support the effectiveness AB-MRI for supplemental screening in women with dense breasts at otherwise average breast cancer risk and suggest that adding screening MRI every two years may be sufficient, though further study is warranted.
1. The cancer detection rate for baseline vs. subsequent AB-MRI exams was 18.9 per 1000 (38/2007) vs. 12.1per 1000 (7/278) respectively (P=.37).
2. The false positive rate decreased from 7.7% (116/1497) for baseline exams to 2.8% (10/359) for subsequent exams (P<.001).
New State Insurance Laws
State Insurance Laws
NEWS on insurance laws for expanded breast imaging in Louisiana, Mississippi, New Hampshire, and Nevada. Currently, 32 states + DC have insurance laws for expanded coverage for either screening or diagnostic imaging. Alaska may be next – that bill is on the governor’s desk – stay tuned!
Amended “Inform” Law, New Study
Rhode Island Density Inform Law Amended
In preparation for the FDA’s new dense breast reporting standard going into effect Sept 10, 2024, Rhode Island has amended its existing “inform” law. The Rhode Island inform law will now defer to the FDA’s national reporting standard. Please see DBI’s State Law Map or Table for details. As previously mentioned, existing state density inform laws may remain in effect in addition to the FDA requirement unless that state law specifically defaults to the new FDA standard, expires, or is repealed.
Just Published
A retrospective study just out in Radiology, Comparison of Mammography and Mammography with Supplemental Whole-Breast US Tomography for Cancer Detection in Patients with Dense Breasts, evaluated the performance of US tomography (UST) combined with full-field digital mammography (FFDM) in a reader study in women with dense breasts. The addition of UST improved cancer detection over FFDM alone and the detection rate was comparable to other ultrasound screening methods.
USPSTF Recommendations, State Insurance Laws
USPSTF Guidelines / Editorial by Dr. Wendie Berg
The United States Preventative Services Task Force (USPSTF) has released a Task Force Recommendation Statement for breast screening. DBI’s Chief Scientific Advisor, Dr Wendie Berg, was invited to respond in an editorial on the key advances and opportunities to enhance breast screening guidelines moving forward: USPSTF Breast Cancer Screening Guidelines Do Not Go Far Enough. [See DBI announcement for a summary of details.]
U.S. State Insurance Laws
Two new states, Iowa and Vermont, have enacted insurance laws for expanded breast imaging coverage after a mammogram.
DBI on Capitol Hill, Density Request Forms
The World’s Leading Resource on Dense Breasts, Now Leads the Fight for the Find It Early Act
DBI had a full schedule on Capitol Hill last week meeting with key Congressional members. The federal bill would ensure all health insurance plans cover screening and diagnostic imaging with no out-of-pocket costs for women with dense breasts or higher risk for breast cancer. WE NEED YOU TO TAKE ACTION. Please share your perspective/examples of denials for coverage for supplemental imaging, resulting delayed screening, unexpected insurance costs, etc., with your congressperson. FYI, congressional members have made it clear that personal direct reach outs are much more effective than petitions. Please contact your congressperson and ask for them to support the bill, learn how HERE.
Patient Density Request Forms
Women out of the U.S. have asked for a resource to request their breast density after their mammograms. DBI features 5 versions of a Patient Density Request Form for specific health systems, the newest version in Arabic.
Density Request forms are available as free downloads:
Kentucky Insurance Law, AI for Supplemental Screening
New U.S. State Insurance Law
The state of Kentucky becomes the 28th state to enact a law requiring some level of insurance coverage for additional breast imaging after a mammogram.
New Study
Just out in Radiology, study Use of an AI Score Combining Cancer Signs, Masking, and Risk to Select Patients for Supplemental Breast Cancer Screening. This large retrospective study found that an AI-based risk model incorporating cancer signs, masking and risk was superior to breast density alone in identifying patients with a negative screening mammogram who were likely to develop subsequent breast cancer. The AI-based risk model, known as AISmartDensity, identified 33% of future cancers compared to 13% for the density-based model.
New State Inform Law, ESR Gold Medal Recipient
U.S. State Inform Law
Better late than never! Indiana has enacted a breast density inform law (effective July 1, 2024) which mirrors the new FDA required “dense breast” reporting language (effective Sept 10, 2024). This brings the number of states with inform laws to 39 and the District of Columbia. Please see DBI’s legislation MAP or TABLE for more details.
European Congress of Radiology – Highlight
Congratulations to Prof. Boris Brkljačić, Chair of the EuroSafe Imaging Steering Committee and DenseBreast-info.org/Europe Education Supporter! Prof. Brkljačić was awarded the ESR Gold Medal, the highest honour bestowed by the society, at the ECR 2024 Opening Ceremony.
New Insurance Bill, State vs FDA “Inform” Requirements
U.S. State Insurance Bill Update
Massachusetts has become the latest state to introduce an insurance bill for expanded breast imaging beyond a mammogram.
State “Inform” Laws and the FDA Reporting Standard
We have received questions about existing state dense breast inform laws and the imminent FDA dense breast reporting standard. It is important to note that existing state density inform laws may remain in effect in addition to the FDA requirement unless that state law specifically defaults to the new FDA standard, expires, or is repealed. FDA guidance is that mammography facilities should be aware of and comply with all applicable local, state, and federal “dense breast” reporting requirements. More information, including how to contact the FDA with questions, is available here.
New Insurance Bills, The Patient’s Perspective
U.S. Insurance bills
New insurance bills for coverage of expanded breast imaging have been introduced in the states of Iowa and Oklahoma.
SBI Newsletter
SBI’s Winter 2024 newsletter includes an interview with DBI’s JoAnn Pushkin, in The Patient’s Perspective column, about the patient dense breast experience, advocacy efforts and next steps on the legislative front.