H.R. 8729: No-Cost Breast Examinations in Medicaid Act of 2026

This bill, known as the No-Cost Breast Examinations in Medicaid Act of 2026, aims to amend the Social Security Act to ensure that certain breast examinations are provided under the Medicaid program without requiring any cost sharing from patients. Here is a breakdown of its key provisions:

Overview

The bill seeks to:

• Eliminate cost sharing for diagnostic and supplemental breast examinations under the Medicaid program.
• Define what constitutes diagnostic and supplemental breast examinations within the context of Medicaid.
• Ensure that screening mammography is included as a mandatory benefit under Medicaid.

Key Provisions

Cost Sharing Elimination

The bill amends specific sections of the Social Security Act to include:

• Adding diagnostic breast examinations and supplemental breast examinations to the list of services covered under Medicaid without patient cost sharing.

Definitions

It provides specific definitions for the types of breast examinations:

• Diagnostic breast examination: A medically necessary evaluation to assess abnormalities found in other screenings or examinations for breast cancer. This may include methods such as diagnostic mammography or breast MRI.
• Supplemental breast examination: A screening method used to detect breast cancer when no abnormalities are present, which is based on individual risk factors or medical history.

Mandatory Benefits

The bill stipulates that screening mammography that meets certain criteria (assigned a grade of A or B by the United States Preventive Services Task Force) must also be covered as a mandatory benefit under Medicaid. This enhancement aims to improve access to preventative care for those at risk of breast cancer.

Effective Date

The changes proposed in this legislation would take effect one year after it becomes law, allowing time for implementation and adjustment within the Medicaid system.

Relevant Companies

• DHR (Danaher Corporation) - A company that produces medical devices and diagnostic equipment related to breast cancer screening and diagnostics might see increased demand for its products as more patients seek no-cost screenings.
• GE (General Electric) - With its healthcare division providing diagnostic imaging equipment, an increase in Medicaid-funded examinations could enhance their business prospects.