Oklahoma § 36-6060 - Mammography screening and diagnostic examination

§ 36-6060. Mammography screening and diagnostic examination

A. For the purposes of this section:

1. "Breast magnetic resonance imaging" means a diagnostic tool

used to produce detailed pictures of the structure of the breast;

2. "Breast ultrasound" means a noninvasive, diagnostic imaging

technique that uses high-frequency sound waves to produce detailed

images of the breast;

3. "Diagnostic examination for breast cancer" means a medically

necessary and clinically appropriate examination, as defined by

current guidelines and as determined by a clinician who is

evaluating the individual for breast cancer, to evaluate the

abnormality in the breast that is:

a.

seen or suspected from a screening examination for

breast cancer,

b.

detected by another means of examination, or

c.

suspected based on the medical history or family

medical history of the individual.

This examination may include, but is not limited to, a contrast–

enhanced mammogram, diagnostic mammogram, breast magnetic resonance

imaging, a breast ultrasound, or molecular breast imaging;

4. "Diagnostic mammography" means a diagnostic tool that:

a.

uses X-ray, and

b.

is designed to evaluate abnormality in a breast;

5. "Health benefit plan" means any plan or arrangement as

defined in subsection C of Section 6060.4 of this title;

6. "Low-dose mammography" means:

a.

the X-ray examination of the breast using equipment

specifically dedicated for such purpose, with an

average radiation exposure delivery of less than one

rad mid-breast and with two views for each breast,

b.

digital mammography, or

c.

breast tomosynthesis;

7. "Breast tomosynthesis" means a radiologic mammography

procedure involving the acquisition of projection images over a

Oklahoma Statutes - Title 36. Insurance

stationary breast to produce cross-sectional digital threedimensional images of the breast from which breast cancer screening

diagnoses may be made;

8. "Screening mammography" means a radiologic procedure

provided to a woman, who has no signs or symptoms of breast cancer,

for the purpose of early detection of breast cancer, including

breast tomosynthesis; and

9. "Supplemental examination" means a medically necessary and

appropriate examination of the breast, including, but not limited

to, such an examination using contrast–enhanced mammography, breast

magnetic resonance imaging, breast ultrasound, or molecular breast

imaging that is:

a.

used to screen for breast cancer when there is no

abnormality seen or suspected, and

b.

based on personal or family medical history or

additional factors that increase the individual's risk

of breast cancer, including heterogeneously or

extremely dense breasts.

B. All health benefit plans shall include the coverage

specified by this section for a low-dose mammography screening for

the presence of occult breast cancer and a diagnostic and

supplemental examination for breast cancer. Such coverage shall

not:

1. Be subject to the policy deductible, co-payments and coinsurance limits of the plan; or

2. Require that a female undergo a mammography screening at a

specified time as a condition of payment.

C. 1. Any female thirty-five (35) through thirty-nine (39)

years of age shall be entitled pursuant to the provisions of this

section to coverage for a low-dose mammography screening once every

five (5) years.

2. Any female forty (40) years of age or older shall be

entitled pursuant to the provisions of this section to coverage for

an annual low-dose mammography screening.

D. If application of this act would result in health savings

account ineligibility under Section 223 of the federal Internal

Revenue Code, as amended, the provisions of this section shall only

apply to health savings accounts with qualified high deductible

health plans with respect to the deductible of such a plan after the

enrollee has satisfied the minimum deductible. Provided, however,

the provisions of this section shall apply to items of services that

are preventive care pursuant to Section 223(c)(2)(c) of the federal

Internal Revenue Code, as amended, regardless of whether the minimum

deductible has been satisfied.

Added by Laws 1988, c. 118, § 9, eff. Nov. 1, 1988. Amended by Laws

1989, c. 287, § 1, eff. Nov. 1, 1989; Laws 1993, c. 165, § 1, eff.

Sept. 1, 1993; Laws 1994, c. 294, § 10, eff. Sept. 1, 1994; Laws

Oklahoma Statutes - Title 36. Insurance

2001, c. 408, § 1, eff. July 1, 2001; Laws 2002, c. 78, § 1, emerg.

eff. April 15, 2002; Laws 2008, c. 184, § 23, eff. July 1, 2008;

Laws 2010, c. 222, § 29, eff. Nov. 1, 2010; Laws 2018, c. 158, § 1,

eff. Nov. 1, 2018; Laws 2022, c. 294, § 1, eff. Nov. 1, 2022; Laws

2025, c. 324, § 1, eff. Nov. 1, 2025.