By: Molly Guthrie
Passage of state and federal legislation that requires
insurers to cover the full cost of diagnostic imaging is a top priority for
Susan G. Komen in 2020.
Under current law, insurers are only required to cover the
cost of annual screening mammograms without pushing costs onto patients. But if
that mammogram reveals an abnormality, patients then must pay out-of-pocket for
any additional medically-necessary diagnostic imaging. Those tests can involve
an ultrasound, breast MRI and diagnostic mammogram to determine if a biopsy is
required. Out-of-pocket cost is particularly burdensome on those who have
previously been diagnosed with breast cancer, as diagnostic tests are often recommended
rather than traditional screening mammography.
A recent Komen-commissioned
study found the costs to patients for these tests to range from $234 for a diagnostic mammogram to $1,021 for a breast MRI. It is estimated that as many
as 10 percent of patients who receive annual screening mammograms get called
back for diagnostic imaging.
At the federal level, the U.S. House of Representatives has
introduced legislation, the Breast Cancer Access to Diagnosis Act that would
eliminate costs for women who need diagnostic tests. Komen continues to meet
with members of the U.S. House to urge passage of its bill, and with the U.S. Senate
to get a companion bill introduced.
At the state level, Texas, Colorado, Illinois, New York and
Louisiana have all passed legislation addressing this issue. More states are expected
to introduce legislation this year and Komen will be working closely with
advocates in those states to get the bills passed and signed into law.
CBS This Morning recently covered the issue and the
financial impact of diagnostic imaging for women who get called back for
If you’ve been called back for a diagnostic test and had to pay any of the costs, we want to hear your story. Please share your experience with us at: https://ww5.komen.org/ShareYourStory.aspx
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