Ban on out-of-pocket charges for breast exams clears first Senate hurdle
TALLAHASSEE, FLA. 1/4/23-Sen. Lori Berman, D-Boynton Beach, during the Senate Education Pre-K-12 Committee, Wednesday at the Capitol in Tallahassee. COLIN HACKLEY PHOTO

A total of 20 other states, including Arkansas, Georgia, Tennessee and Texas, have adopted similar legislation.

A bill that would prohibit state insurers from charging out-of-pocket costs for medically necessary breast cancer examinations is headed to a second Senate stop after clearing its first panel with ample support.

The measure (SB 932) wouldn’t require insurers to provide new coverage. It would simply amend patient cost-sharing rules in Florida Statutes to ban insurance companies from demanding what in some cases are cost-prohibitive copays for diagnostic and supplemental breast exams.

“We all know early detection of breast cancer saves lives, and by having this bill we will be saving lives,” said Boynton Beach Democratic Sen. Lori Berman, the measure’s sponsor.

Berman, a breast cancer survivor, noted that 20 other states — including Arkansas, Georgia, Tennessee and Texas — have adopted similar legislation.

“I hope Florida will join (them) in becoming No. 21,” she told the Senate Banking and Insurance Committee, which voted 9-0 Monday to advance the bill.

Free mammograms are available today in Florida. But in cases where an abnormality is detected or the patient has a family history of breast cancer, mammograms are just the first step. Doctors must then perform diagnostic and supplemental examinations, including MRIs and ultrasounds, to determine the need for a biopsy and additional measures.

More than 22,670 Floridians received breast cancer diagnoses last year. About 3,170 died of the disease, according to the nonprofit Susan G. Komen, which blames “exorbitant out-of-pocket costs associated with essential breast imaging procedures” as contributing to those figures.

A 2019 study the organization commissioned found that out-of-pocket costs for patients ranged from $234 for a diagnostic mammogram to more than $1,000 for a breast MRI. About 12% of women screened with modern digital mammography require follow-up imaging or biopsy, according to the American Cancer Society. But alarmingly, the Komen study revealed that 1 in 5 patients are likely to forgo recommended follow-up imaging if they have to pay a deductible.

The cost of those examinations has likely risen, according to Berman, who told the committee a “former colleague” of theirs texted her about the bill.

“She said, ‘I just had to go do a test and it cost me $1,200,’” Berman said. “This is a really good bill, and it will really change things in the cancer field and make sure that people get the follow-up treatment that they need.”

Representatives from the Florida Breast Cancer Foundation and AARP Florida agreed, signaling approval of Berman’s bill.

Susan Harbin, senior government relations director for the American Cancer Society’s Cancer Action Network, described how important early prevention is to surviving breast cancer.

“There’s more than a 90% survival rate when they’re diagnosed early and they’re still localized,” she said.

“If there’s an abnormal first mammogram, you may have to come in for a supplemental mammogram or breast MRI. A lot of times patients encounter these out-of-pocket costs that are a barrier to treatment, and we know that even a three-month delay in treatment can lead to a later-stage diagnosis … so this is an incredibly important bill.”

SB 932, which Jacksonville Democratic Sen. Tracie Davis is cosponsoring, is to next receive a hearing before the Senate Appropriations Committee on Agriculture, Environment and General Government. It has one more stop after that before heading to the chamber floor.

A House companion (HB 773) by Hollywood Democratic Rep. Marie Woodson awaits a hearing before the first of three committees to which Speaker Paul Renner referred it last month.

Jesse Scheckner

Jesse Scheckner has covered South Florida with a focus on Miami-Dade County since 2012. His work has been recognized by the Hearst Foundation, Society of Professional Journalists, Florida Society of News Editors, Florida MMA Awards and Miami New Times. Email him at [email protected] and follow him on Twitter @JesseScheckner.


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