Lawmaker pushes to eliminate OOP costs for supplemental breast imaging

A member of the Missouri House of Representatives recently introduced legislation that would increase access to supplemental breast imaging by eliminating out-of-pocket expenses for the exams. 

On Jan. 4, Representative Brenda Shields introduced a proposal (HB 575) that would remove financial barriers for women who are recommended to undergo supplemental breast imaging, such as an MRI, CT or ultrasound, when the exams are deemed medically necessary.

Shields, who worked alongside the Susan G. Komen organization to develop the bill, maintains that, if enacted, the legislation would save lives.

"When the threat of breast cancer rears its head, women and their doctors need every tool available to for an accurate diagnosis," Rep. Shields said in prepared remarks. “This bill will save lives by ensuring treatment can begin as early as possible." 

Molly Guthrie, Vice President of Policy and Advocacy at Susan G. Komen, applauded Shields for her advocacy on behalf of Komen, stating that the legislation would have an immediate impact for thousands of women who need supplemental imaging but cannot afford it. 

"Everyone should be able to access the care they need and afford it, especially when it could mean the difference between a person's life and death," Guthrie stated. 

While the U.S. government mandates coverage of routine mammographic breast cancer screening based on recommended guidelines pertaining to age, risk, etc., coverage of supplemental imaging often falls in the laps of patients. 

According to a study commissioned by Komen, supplemental breast imaging can exceed thousands of dollars in OOP costs, preventing many women from following through with radiologists’ recommendations. And another recent study echoing that same sentiment found that more than 20% of women would forego supplemental imaging due to high deductibles and OOP expenses, especially in more vulnerable populations. 

The proposed effective date of the bill is Aug. 28, 2023, but it has not yet made its way to the House calendar. 

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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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