Breast Cancer Screening Benefit in Every Health

Insurance Policy.

(a)

(1)Every policy of health insurance issued or renewed to a resident of Guam on or after January 1, 2019, except a policy that provides coverage only for specified and limited benefits, shall provide coverage for screening by low-dose mammography for occult breast cancer as follows:

(A)for women thirty-five

(35)to thirty-nine

(39)years of age, one

(1)baseline mammogram;

(B)for women forty

(40)years of age and older, an annual mammogram; and

(C)for a woman of any age, and for men beginning at age forty

(40)who have a first-degree consanguineous relative that was diagnosed to have developed breast cancer at forty

(40)years of age or younger, mammogram screening may be performed as recommended by the patient’s physician, but not more than once annually.

(2)The services provided in this Section are not subject to any coinsurance or deductible provisions which may be in force in such policies, contracts, plans or agreements for routine x-ray examinations.

(b)The term, “low-dose mammography” means the x-ray examination of the breast using equipment dedicated specifically for mammography, including, but not limited to, the x-ray tube, filter, compression device, screens, films, and cassettes, with an average radiation exposure delivery of less than one

(1)rad midbreast, with two

(2)views for each breast, or digital breast tomosynthesis (DBT), or full-field digital mammography (FFDM).

(1)Digital breast tomosynthesis

(DBT)is a form of breast imaging, or mammography, that uses a low-dose xray system and computer reconstructions to create threedimensional images of the breasts.

(2)Full-field digital mammography

(FFDM)is a mammography system in which the x-ray film is replaced COL6/24/2021 CH. 18 THE CONTRACT OF INSURANCE by electronics that convert x-rays into mammographic pictures of the breast.

(c)To the extent permitted by federal law, rules, and regulations, the provisions of this Section, supra, shall apply to persons covered by Medicaid without the requirement for precertification. The provisions of this Section, supra, shall also apply to persons covered by the Medically Indigent Program

(MIP)without the requirement for precertification.