Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 314 (2025GS)

Sponsor

Rep. Dailey-Provost, Jennifer

Final action

House/ filed 3/7/2025

Outcome

Failed / filed without passage

Summary

What it does

• This bill:
• defines terms; and
• prohibits a health benefit plan from implementing a cost-sharing requirement for certain breast examinations that detect breast cancer.

Every vote on this bill

Bill text

3
31A-22-630.1
Breast Cancer Prevention Modifications
2025 GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Jennifer Dailey-Provost
LONG TITLE
General Description:
This bill amends provisions related to health insurance and breast examinations that detect 
breast cancer.
Highlighted Provisions:
This bill:
defines terms; and
prohibits a health benefit plan from implementing a cost-sharing requirement for certain 
breast examinations that detect breast cancer.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
ENACTS:
31A-22-630.1
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1, Section 
31A-22-630.1
 is enacted to read:
31A-22-630.1. Breast exam cost sharing.
(1)
As used in this section:
(a)
"Cost-sharing requirement" means any copayment, coinsurance, deductible, or 
annual limitation on out-of-pocket expenses required by a health benefit plan for a 
specific health care service covered by the health benefit plan.
(b)
(i)
"Breast examination" means a medical examination of the breast conducted by 
a health care professional.
(ii)
"Breast examination" includes:
(A)
contrast-enhanced mammography;
(B)
diagnostic mammography;
(C)
breast magnetic resonance imaging; and
(D)
breast ultrasound.
(c)
"Diagnostic breast examination" means a medically necessary breast examination 
that is used to evaluate an abnormality that was detected or suspected after another 
means of examination, including a previous breast examination.
(d)
"Supplemental breast examination" means a medically necessary breast examination 
that is used to screen for breast cancer:
(i)
when there is no prior indication that a breast health abnormality exists or is 
suspected;
(ii)
based on personal or family medical history; or
(iii)
based on additional factors that increase an individual's risk of breast cancer.
(2)
A health benefit plan that provides benefits with respect to diagnostic breast 
examinations or supplemental breast examinations may not require an enrollee to pay a 
cost-sharing requirement for a diagnostic breast examination or a supplemental breast 
examination.
(3)
A diagnostic breast examination or a supplemental breast examination is medically 
necessary if the examination is provided in accordance with the National 
Comprehensive Cancer Network Guidelines.
Section 2. 
Effective Date.
This bill takes effect on 
May 7, 2025
.
1-23-25 2:51 PM