The U.S. Health Resources and Services Administration (HRSA) has updated the Women's Preventive Services Guidelines, which now include new breast cancer screening coverage guidelines for average-risk women.
The updated guidelines are now in effect and require private insurers to cover regular mammography screening for average-risk women age 40 and older.
Under the Patient Protection and Affordable Care Act (ACA), private insurers are required, with certain exceptions, to cover preventive care and screening exams recommended by HRSA, or those that receive a grade of "A" or "B" by the U.S. Preventive Services Task Force (USPSTF), without a co-payment, co-insurance, deductible, or other cost-sharing. USPSTF's failure in 2009 and 2016 to give an "A" or "B" grade to routine mammography screening for women ages 40 to 49 prompted Congress to pass legislation to ensure coverage for these women.
HRSA guidelines recommend the following for women with an average risk of breast cancer:
- Have a mammography screening no earlier than age 40 and no later than age 50.
- Be screened at least biennially and as frequently as annually.
- Continue screening through at least age 74 and possibly older.
Dr. Debra Monticciolo, chair of the American College of Radiology Breast Imaging Commission, said the HRSA recommendations protect women's access to screening at the time and frequency of their choosing, which collectively has the best chance to save lives.
