Washington State SB 5912 implementation: 3D mammography

Greetings,

In March, 2018, the Washington state Legislature passed SB 5912, clarifying that health plan coverage of mammograms must include coverage of “digital tomosynthesis”, otherwise known as “three-dimensional (3D) mammography.”  The Legislature noted that the American college of radiology has indicated that 3D mammography is no longer investigational. 

In SB 5912, the Legislature directed the Office of the Insurance Commissioner to clarify that the existing mandates for mammography in RCW 48.20.393, 48.21.225, 48.44.325, and 48.46.275 include coverage for 3D mammography under the same terms and conditions currently allowed for mammography.

This message is being sent to provide that clarification.  Every health plan is required to cover mammography under the statutes cited above.  Under SB 5912, this coverage must include “the most effective breast imaging”: 3D mammography.   Like all methods of mammography, coverage of 3D mammography may not be subject to any cost sharing, including deductibles, copays, and coinsurance, consistent with 42 U.S.C. Sec. 300-gg-13.