The Arizona Revised Statutes have been updated to include the revised sections from the 57th Legislature, 2nd Regular Session. Please note that the next update of this compilation will not take place until after the conclusion of the 58th Legislature, 1st Regular Session, which convenes in January 2027.
This online version of the Arizona Revised Statutes is primarily maintained for legislative drafting purposes and reflects the version of law that is effective on January 1st of the year following the most recent legislative session. The official version of the Arizona Revised Statutes is published by Thomson Reuters.
20-1057.21. Breast examinations; cost sharing; exception; definitions
A. A health care services organization that issues, amends, delivers or renews an evidence of coverage on or after January 1, 2027 may not impose cost sharing requirements for preventative screening services for breast cancer or for additional screening services required to complete the screening continuum.
B. If an evidence of coverage includes a high deductible health plan as defined in 26 United States Code section 223(c)(2)(A), subsection A of this section applies after the deductible is met, except that if the items or services are preventive as prescribed in 26 United States Code section 223(c)(2)(C), subsection A of this section applies regardless of whether the minimum deductible under 26 United States Code section 223 has been met.
C. For the purposes of this section:
1. "Additional screening services" includes a diagnostic breast examination and a supplemental breast examination.
2. "Cost sharing" means a deductible, coinsurance, copayment or maximum limitation on the application of the deductible, coinsurance, copayment or similar out-of-pocket expense.
3. "Diagnostic breast examination":
(a) Means a medically necessary and appropriate examination of the breast in accordance with the national comprehensive cancer network guidelines.
(b) Includes an examination of the breast using contrast enhanced mammography, diagnostic mammography, breast magnetic resonance imaging or breast ultrasound or molecular breast imaging that is used to either:
(i) Evaluate an abnormality that is seen or suspected from a screening examination for breast cancer.
(ii) Evaluate an abnormality that is detected by another means of examination.
4. "Preventative screening services for breast cancer" means screening mammography as defined in section 30-651.
5. "Supplemental breast examination":
(a) Means a medically necessary and appropriate examination of the breast in accordance with the national comprehensive cancer network guidelines.
(b) Includes an examination of the breast using contrast enhanced mammography, breast magnetic resonance imaging or breast ultrasound or molecular breast imaging that is both:
(i) Used to screen for breast cancer when there is no abnormality seen or suspected.
(ii) Based on a personal or family medical history or additional factors that increase an individual's risk of breast cancer, including heterogenous or extremely dense breasts.