HB 2561 would prohibit certain Arizona health insurers and health coverage entities from charging cost sharing for diagnostic breast examinations and supplemental breast examinations beginning on or after January 1, 2026. The bill applies to hospital service corporations, medical service corporations, health care services organizations, disability insurers, and group or blanket disability insurers. It defines cost sharing to include deductibles, coinsurance, copayments, and similar out-of-pocket expenses.
The bill defines diagnostic breast examinations as medically necessary breast imaging used to evaluate an abnormality seen or suspected on a screening exam or detected by another means, including contrast-enhanced mammography, diagnostic mammography, MRI, or ultrasound. It defines supplemental breast examinations as medically necessary imaging used to screen for breast cancer when no abnormality is seen or suspected, or when based on personal or family history or other risk factors. The definitions reference National Comprehensive Cancer Network guidelines.
Impact
HB 2561 would amend multiple sections of Title 20 of the Arizona Revised Statutes governing different types of health coverage, creating a uniform no-cost-sharing requirement for specified breast imaging services across several insurance markets. If enacted, it would limit insurers’ ability to apply deductibles, copays, or coinsurance to these exams and would likely increase coverage obligations for affected carriers while reducing out-of-pocket costs for patients needing breast cancer diagnostic or supplemental imaging.
Sentiment
The available legislative record shows limited formal action and no recorded committee vote outcome beyond a House Health & Human Services Committee action marked withdrawn. There are no committee transcripts provided, so there is no documented floor or committee debate to indicate broad support or opposition. Based on the bill’s subject matter, the measure appears to be a patient-protection and breast cancer screening access proposal, but the procedural history suggests it did not advance in the available record.
Contention
The main policy issue is whether insurers should be barred from imposing cost sharing on advanced breast imaging, which shifts costs from patients to health plans. Supporters would likely emphasize earlier detection, reduced financial barriers, and alignment with cancer screening guidelines, while opponents or cost-conscious stakeholders may raise concerns about premium impacts, utilization, and the breadth of the supplemental imaging definition. The bill’s use of NCCN guidelines and inclusion of imaging based on family history or risk factors may also be a point of discussion for insurers and medical policy reviewers.