[Congressional Record Volume 171, Number 133 (Friday, August 1, 2025)]
[Senate]
[Pages S5468-S5469]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 3675. Mrs. BRITT (for herself and Mrs. Shaheen) submitted an 
amendment intended to be proposed by her to the bill S. 2296, to 
authorize appropriations for fiscal year 2026 for military activities 
of the Department of Defense, for military construction, and for 
defense activities of the Department of Energy, to prescribe military 
personnel strengths for such fiscal year, and for other purposes; which 
was ordered to lie on the table; as follows:

       At the appropriate place, insert the following:

     SEC. __. REQUIRING DIAGNOSTIC AND SUPPLEMENTAL BREAST 
                   EXAMINATIONS TO BE COVERED WITH NO COST-SHARING 
                   REQUIREMENTS.

       (a) In General.--Subpart II of part A of title XXVII of the 
     Public Health Service Act (42 U.S.C. 300gg-11 et seq.) is 
     amended by adding at the end the following new section:

     ``SEC. 2730. DIAGNOSTIC AND SUPPLEMENTAL BREAST EXAMINATIONS.

       ``(a) In General.--In the case of a group health plan, or a 
     health insurance issuer offering group or individual health 
     insurance coverage, that provides benefits with respect to 
     diagnostic and supplemental breast examinations furnished to 
     an individual enrolled under such plan or such coverage, such 
     plan or coverage shall not impose any cost-sharing 
     requirements for these benefits.
       ``(b) Construction.--Nothing in this section shall be 
     construed--
       ``(1) to prohibit a group health plan or health insurance 
     issuer from requiring timely prior authorization or imposing 
     other appropriate utilization controls in approving coverage 
     for any diagnostic and supplemental breast examination; or
       ``(2) to supersede a State law that provides greater 
     protections with respect to the coverage of diagnostic and 
     supplemental breast examinations than is provided under this 
     section.
       ``(c) Definitions.--In this section:

[[Page S5469]]

       ``(1) Cost-sharing requirements.--The term `cost-sharing 
     requirements' means a deductible, coinsurance, copayment, and 
     any maximum limitation on the application of such a 
     deductible, coinsurance, copayment or similar out-of-pocket 
     expense.
       ``(2) Diagnostic breast examination.--The term `diagnostic 
     breast examination' means a medically necessary and 
     appropriate (in accordance with National Comprehensive Cancer 
     Network Guidelines) examination of the breast (including, but 
     not limited to such an examination using diagnostic 
     mammography, breast magnetic resonance imaging, or breast 
     ultrasound) that is--
       ``(A) used to evaluate an abnormality seen or suspected 
     from a screening examination for breast cancer; or
       ``(B) used to evaluate an abnormality detected by another 
     means of examination.
       ``(3) Supplemental breast examinations.--The term 
     `supplemental breast examination' means a medically necessary 
     and appropriate (in accordance with National Comprehensive 
     Cancer Network Guidelines) examination of the breast 
     (including, but not limited to such an examination using 
     breast magnetic resonance imaging or breast ultrasound) that 
     is--
       ``(A) used to screen for breast cancer when there is no 
     abnormality seen or suspected; and
       ``(B) furnished based on personal or family medical history 
     or additional factors that may increase the individual's risk 
     of breast cancer.''.
       (b) Application to Grandfathered Health Plans.--Section 
     1251(a)(4)(A) of the Patient Protection and Affordable Care 
     Act (42 U.S.C. 18011(a)(4)(A)) is amended--
       (1) by striking ``title'' and inserting ``title, or as 
     added after the date of the enactment of this Act''; and
       (2) by adding at the end the following new clause:
       ``(v) Section 2730 (relating to coverage for diagnostic and 
     supplemental breast examinations).''.
       (c) Application to High Deductible Health Plans With Health 
     Savings Account Eligibility.--Section 223(c)(2) of the 
     Internal Revenue Code of 1986 is amended by adding at the end 
     the following:
       ``(H) Safe harbor for absence of deductible for diagnostic 
     and supplemental breast examinations.--In the case of plan 
     years beginning on or after January 1, 2026, a plan shall not 
     fail to be treated as a high deductible health plan by reason 
     of failing to have a deductible for diagnostic and 
     supplemental breast examinations.''.
       (d) Effective Date.--The amendments made by this section 
     shall apply with respect to plan years beginning on or after 
     January 1, 2026.
                                 ______