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H.R. 10100IntroducedHouse · nowSenatePresidentLawIn committee
Sec. 2 · H.R. 10100

No-cost coverage of annual screening mammography beginning at 30 years of age

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(a) Coverage under Medicare (1) In general Section 1834(c) of the Social Security Act (42 U.S.C. 1395m(c)) is amended— (A) in paragraph (1)(A), by inserting or (3) after paragraph (2); (B) in paragraph (2)— (i) by striking the paragraph heading and inserting Frequency covered before January 1, 2027; and (ii) in subparagraph (A), by striking Subject and inserting With respect to screening mammography performed before January 1, 2027, subject; and (C) by adding at the end the following new paragraph: (3) Frequency covered on or after January 1, 2027 With respect to screening mammography performed on or after January 1, 2027— (A) no payment may be made under this part for screening mammography performed on a woman under 30 years of age; and (B) in the case of a woman over 29 years of age, payment may not be made under this part for screening mammography performed within 11 months following the month in which a previous screening mammography was performed.. (2) Prohibition of cost sharing Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended— (A) in subparagraph (Y), by inserting after in the case of such services described in subparagraph (A) the following: (other than screening mammography (as defined in section 1861(jj)) performed on or after January 1, 2027); (B) in subparagraph (GG), by striking and at the end; and (C) by inserting before the semicolon at the end the following:, and (II) with respect to screening mammography (as defined in section 1861(jj)) performed on or after January 1, 2027, the amounts paid shall be shall be 100 percent of the lesser of the actual charge for the services or the amount determined under the fee schedule that applies to such services under this part. (3) Conforming amendment Section 1862(a)(1)(F) is amended by striking section 1834(c)(2) and inserting section 1834(c). (b) Coverage under Medicaid (1) Inclusion under diagnostic, screening, preventive, and rehabilitative services Section 1905(a)(13) of the Social Security Act (42 U.S.C. 1396d(a)(13)) is amended— (A) in subparagraph (B), by striking and at the end; (B) in subparagraph (C), by adding and at the end; and (C) by adding at the end the following new subparagraph: (D) for women over age 29, annual screening mammography;. (2) Increased FMAP Section 1905(b)(5) of the Social Security Act (42 U.S.C. 1396d(b)(5)) is amended by striking described in subsection (a)(13)(A) and inserting described in subparagraphs (A) and (D) of subsection (a)(13). (3) Effective date The amendments made by this subsection shall apply with respect to items and services furnished on or after January 1, 2027. (c) Coverage under group health plans and group and individual health insurance (1) In general Section 2713(a) of the Public Health Service Act (42 U.S.C. 300gg–13(a)) is amended— (A) in paragraph (2), by striking at the end and; (B) in paragraph (3), by striking at the end the period and inserting; and; and (C) in paragraph (4)— (i) by striking at the end the period and inserting; and; (ii) by striking women, such and inserting women— (A) such; and (iii) by adding at the end the following new subparagraph: (B) in the case of a woman over 29 years of age, annual mammography screening.. (2) Effective date The amendments made by this subsection shall apply to plan years beginning on or after January 1, 2027.

Sec. 2: No-cost coverage of annual screening mammography beginning at 30 years of age · Public Law Tracker