HR 8729
No-Cost Breast Examinations in Medicaid Act of 2026
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- Passed House
- Passed Senate
- To President
- Became Law
Bill overview
This bill, the No-Cost Breast Examinations in Medicaid Act of 2026, aims to make diagnostic and supplemental breast examinations available to Medicaid recipients without requiring them to pay any costs. It amends existing Medicaid regulations to include these examinations as covered services and to specifically define what constitutes a diagnostic and supplemental breast examination, aligning with established guidelines. The bill also mandates that screening mammography be included as a mandatory benefit under Medicaid.
Key provisions
- Requires diagnostic and supplemental breast examinations to be provided without cost-sharing under Medicaid.
- Defines ‘diagnostic breast examination’ and ‘supplemental breast examination’ according to established guidelines.
- Includes screening mammography as a mandatory benefit for Medicaid recipients.
- Modifies Medicaid regulations to align with National Comprehensive Cancer Network Guidelines.
- Updates definitions related to breast cancer examinations within the Social Security Act.
Who is affected
- Medicaid recipients
- Individuals eligible for Medicaid coverage
- Healthcare providers who administer Medicaid services
Notable changes
- Expands Medicaid coverage to include diagnostic and supplemental breast examinations.
- Establishes clear definitions for these examinations.
- Mandates screening mammography as a standard benefit.
Sponsors
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Primary sponsor
Cosponsor
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119th CONGRESS — 2d Session
H. R. 8729
IN THE HOUSE OF REPRESENTATIVES
A BILL
To amend title XIX of the Social Security Act to require that diagnostic and supplemental breast examinations are furnished without cost sharing under the Medicaid program, and for other purposes.
This Act may be cited as the No-Cost Breast Examinations in Medicaid Act of 2026
.
in subparagraph (I), by striking or
at the end;
in subparagraph (J), by striking ; and
and inserting , or
; and
by adding at the end the following new subparagraph:
diagnostic breast examinationmeans 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—
supplemental breast examinationmeans 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—
(13)(D),after
(13)(B),.
Section 1905(a)(13) of the Social Security Act (42 U.S.C. 1396d(a)(13)) is amended—
in subparagraph (B), by striking and
at the end;
in subparagraph (C), by adding and
at the end; and
by adding at the end the following new subparagraph:
The amendments made by this section shall apply with respect to medical assistance furnished on or after the date that is 1 year after the date of the enactment of this Act.