LIBERTY, Mo. — A new law in Missouri requires health insurance companies to pay the full cost of diagnostic breast imaging without charging patients a co-pay or deductible. Gov. Mike Parson signed SB106 last week; it will take effect Jan. 1, 2024.
Dr. Amy Patel, the medical director of the Breast Care Center at Liberty Hospital, spearheaded the change.
“For me, it’s really a mission to ensure women are receiving equitable care, not just in the area I serve, but in the state of Missouri,” Patel said.
She explained diagnostic breast imaging takes place after an initial screening when doctors want to follow up with a symptom detected in the screening exam, or when a patient has a high risk of breast cancer. Missouri already requires insurance providers to pay for initial screenings under most circumstances.
Diagnostic breast imaging can include a 3D mammogram, MRI or ultrasound. Those tools allow doctors to detect cancer early, when patients have more treatment options and a higher chance of beating the cancer. Patel has had patients delay diagnostic imaging because of fears about costs.
“Any age is heartbreaking, but it’s the cases I see when they’re younger - in their late 20s or early 30s - who can’t afford the cost of a diagnostic mammogram and possible ultrasound; those are essentially the patient stories that stick with me,” Patel said.
One loophole is the law only applies to insurance companies operating under the Missouri constitution. So Missouri residents with insurance based in another state would not qualify. About a dozen other states have a similar law. Patel’s next step is to make Missouri’s law a federal law, thus eliminating the discrepancy between states.
Patel worked with State Representative Brenda Shields from the St. Joseph area and Susan G. Komen to make the law a reality. This is the third law Patel has helped pass in Missouri. In 2018, a new law required insurance companies to cover more breast cancer screening exams. In 2020, a law required insurance companies to cover more examinations for women with a high risk of breast cancer.
