1. (1) As used in this section:

   1. (a) “Diagnostic breast examination” means an examination used to evaluate an abnormality of the breast that is detected or suspected from a screening examination for breast cancer or by any other means of examination using:

      1. (A) Diagnostic mammography;
      2. (B) Breast magnetic resonance imaging; or
      3. (C) Breast ultrasound.

   2. (b) “Supplemental breast examination” means an examination of the breast, such as breast magnetic resonance imaging or breast ultrasound, that is:

      1. (A) Used to screen for breast cancer when there is no abnormality seen or suspected; and
      2. (B) Based on personal or family medical history or other factors that increase an individual’s risk of breast cancer.

2. (2) Except as provided in ORS 742.008, a carrier offering a group health benefit plan or an individual health benefit plan in this state that reimburses the cost of supplemental or diagnostic breast examinations may not impose on the coverage of a medically necessary supplemental or diagnostic breast examination:

   1. (a) A deductible;
   2. (b) Coinsurance;
   3. (c) A copayment; or
   4. (d) Other out-of-pocket expenses.

Note: See 743A.001.

Note: Definitions for 743A.101 may be found in 743B.005.

Note: 743A.101 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743A or any series therein. See Preface to Oregon Revised Statutes for further explanation.

[2023 c.468 §2]