Out-of-Pocket Costs for Diagnostic Mammograms Eliminated

Out-of-Pocket Costs for Diagnostic Mammograms Eliminated
Thanks to House Bill 170, Komen San Antonio, and Rep. Diego Bernal (TX-123)

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San Antonio (September 24, 2019) – Texas residents no longer have to cover the costs of diagnostic imaging for mammograms, thanks to House Bill 170, which took effect September 1.

During the 2019 Texas Legislative Session, Susan G. Komen San Antonio partnered with Texas Representative Diego Bernal to sponsor HB 170, which eliminates the patient’s out-of-pocket costs for diagnostic mammograms.

Traditional screening mammography is typically covered at no cost to patients, but after a lump or other signs of disease have been found, the diagnostic imaging for Texas patients with private insurance varied from $336 to $836. HB 170 eliminates this cost by requiring plans to fully cover diagnostic mammography. Governor Greg Abbot signed the bill into law on June 15, 2019.

“No woman should ever have to worry about whether or not they can afford the life saving healthcare they need. Now when it comes to those who require diagnostic mammograms, many women will be taken care of.” – Representative Diego Bernal.

“HB 170 will allow more women in Texas to receive the diagnostic imaging required to identify whether or not they have breast cancer, leading to saved lives through earlier detection and treatment,” Elyse Bernal, executive director of Susan G. Komen San Antonio, states.

Komen also supported HB 1584 by Representative Senfronia Thompson (TX-141), which eliminated step therapy protocols for metastatic, stage four cancer patients. Step therapy, also referred to as “fail first”, is a utilization management tool that requires a patient to first try a preferred (often generic alternative) drug prior to receiving coverage for the originally prescribed drug. HB 1584 eliminates step therapy for cancer treatments and associated conditions for metastatic, advanced stage-four cancer patients. Texas became one of only a handful of states to enact this legislation.

“Patients and physicians should have the opportunity to choose the best treatments and therapies without the burden of overly restrictive cost containment policies,” Bernal states. Both laws took effect September 1, 2019.

About Susan G. Komen San Antonio
Komen San Antonio is helping fuel research, advocate for patients, and support people facing breast cancer locally through a variety of direct patient-centered services and by collaborating with area providers to remove barriers and connect people to needed care across Bexar County. For more information, call (210) 222-9009 or visit komensanantonio.org