Legislature Considers Bill to Promote Access to Diagnostic and Supplemental Breast Exams

Legislature Considers Bill to Promote Access to Diagnostic and Supplemental Breast Exams - Healthcare Law Update - June 2025 - Brach Eichler
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6/1/2025

Assembly Bill 5542, introduced in the New Jersey Assembly on April 10, 2025, would require health insurance coverage of diagnostic breast examinations and supplemental breast examinations, without imposing cost-sharing obligations on patients. “Diagnostic breast examination” would be defined as a medically necessary and appropriate examination for breast cancer screening to evaluate an abnormality seen or suspected from an initial screening. “Supplemental breast examination” would be defined as a medically necessary and appropriate examination for breast cancer screening when no abnormality is initially seen or suspected, but is otherwise recommended based on an individual’s personal or family medical history, or other factors that elevate their risk. The types of tests included in the Bill are contrast-enhanced mammography, breast magnetic resonance imaging, breast ultrasound, and molecular breast imaging.

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For more information, contact:
John D. Fanburg, Chair | 973.403.3107 | jfanburg@bracheichler.com
Edward Hilzenrath | 973.403.3114 | ehilzenrath@bracheichler.com
Rebecca T. Falk | 973.364.8393 | rfalk@bracheichler.com

*This is intended to provide general information, not legal advice. Please contact the authors if you need specific advice.

Related Practices:   Healthcare Law

Related Industry:   Healthcare