To amend titles XVIII and XIX of the Social Security Act and title XXVII of the Public Health Service Act to provide for no-cost coverage for annual screening mammography beginning at 30 years of age.

To amend titles XVIII and XIX of the Social Security Act and title XXVII of the Public Health Service Act to provide for no-cost coverage for annual screening mammography beginning at 30 years of age.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. Short title.

SEC. 2. No-cost coverage of annual screening mammography beginning at 30 years of age.

(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.