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Primary Sponsor

Last Action

Ref To Com On Rules and Operations of the Senate2025-05-07

Vote Breakdown

Plain Language Summary

This bill requires health insurance plans in North Carolina to cover supplemental and diagnostic breast imaging (such as MRI and ultrasound) with the same cost-sharing as standard mammograms. It also prevents out-of-network providers from billing patients above insurance-approved rates for these breast cancer prevention services.

Arguments in Favor

• •Supporters argue this bill improves breast cancer detection by ensuring patients have access to advanced imaging technologies without financial barriers.
• •They contend that women at high risk or with dense breast tissue benefit from supplemental imaging, and standardized cost-sharing removes insurance discrimination that could delay lifesaving care.
• •Additionally, the billing restrictions prevent surprise bills from out-of-network providers.

Arguments Against

• •Opponents may argue the bill increases insurance costs by mandating coverage of additional imaging services, which could raise premiums for all policyholders.
• •They may also contend that limiting out-of-network provider reimbursement rates could discourage providers from participating in networks or reduce availability of services in certain areas.
• •Some may question whether all recommended supplemental imaging is medically necessary for every patient.