No-Cost Breast Examinations in Medicaid Act of 2026

Subsections (a)(2) and (b)(2) of section 1916 of the Social Security Act (42 U.S.C. 1396o) are each amended—

(A) in subparagraph (I), by striking or at the end;

(B) in subparagraph (J), by striking; and and inserting, or; and

(C) by adding at the end the following new subparagraph:

(K) diagnostic breast examinations and supplemental breast examinations (as such terms are defined in section 1905(ll)); and.

Section 1916A(b)(3)(B) of the Social Security Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended by adding at the end the following new clause:

(xv) Diagnostic breast examinations and supplemental breast examinations (as such terms are defined in section 1905(ll)).

Section 1905 of the Social Security Act (42 U.S.C. 1396d) is amended by adding at the end the following new subsection:

The term diagnostic breast examination means a medically necessary and appropriate (in accordance with National Comprehensive Cancer Network Guidelines) examination of the breast (including, but not limited to such an examination using diagnostic mammography, breast magnetic resonance imaging, or breast ultrasound) that is—

(A) used to evaluate an abnormality seen or suspected from a screening examination for breast cancer; or

(B) used to evaluate an abnormality detected by another means of examination.

The term supplemental breast examination means a medically necessary and appropriate (in accordance with National Comprehensive Cancer Network Guidelines) examination of the breast (including, but not limited to such an examination using breast magnetic resonance imaging or breast ultrasound) that is—

(A) used to screen for breast cancer when there is no abnormality seen or suspected; and

(B) furnished based on personal or family medical history or additional factors that may increase the individual’s risk of breast cancer.

Section 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended, in the matter preceding clause (i), by inserting (13)(D), after (13)(B),.

Section 1905(a)(13) of the Social Security Act (42 U.S.C. 1396d(a)(13)) is amended—

(A) in subparagraph (B), by striking and at the end;

(B) in subparagraph (C), by adding and at the end; and

(C) by adding at the end the following new subparagraph:

(D) screening mammography (as defined in section 1861(jj)) assigned a grade of A or B by the United States Preventive Services Task Force;.

The amendments made by this section shall apply with respect to medical assistance furnished on or after the date that is 1 year after the date of the enactment of this Act.