New Missouri law impacts diagnostic testing

    Authored by Bukaty Companies on July 13, 2023

    Missouri Governor Mike Parson recently signed SB106 into law, which modifies an array of provisions regarding public health. Starting January 1, 2024, Missouri will require health insurance carriers to foot the bill for diagnostic breast imaging. The provision aims to combat breast cancer by reducing costs and eliminating financial barriers that prevent women from seeking breast screenings.

    Diagnostic imaging is used to detect early-stage cancer, giving patients more time for intervention and broader options for courses of treatment. People with an elevated risk of developing breast cancer are often ordered to undergo diagnostics, as well as those who show symptoms of cancer in screening exams. Imaging could include 3D mammograms, ultrasounds and MRIs.  

    Carriers will not be allowed to charge patients a copay or deductible for the service. Cost-sharing will also be prohibited for supplemental breast examinations and low-dose mammography screenings. Missouri had previously only required insurance carriers to pay for initial screening exams, with few exceptions. 

    Certain mammography facilities are also prohibited from requiring referrals from primary care providers for mammogram screenings that are consistent with the most recent recommendation guidelines set forth by the American College of Radiology. 

    Blog Category: Compliance