‘‘(ii) beginning on January 1, 2023, in ad-
dition to any other items or services described 
in this subsection— 
‘‘(I) with respect to an individual who 
is at increased risk of breast cancer (as de-
termined in accordance with the most re-
cent applicable American College of Radi-
ology Appropriateness Criteria or the most 
recent applicable guidelines of the National 
Comprehensive Cancer Network) or with 
heterogeneously or extremely dense breast 
tissue (as defined by the Breast Imaging 
Reporting and Data System established by 
the 
American 
College 
of 
Radiology), 
screening and diagnostic imaging (with no 
limitation applied on frequency) for the de-
tection of breast cancer, including 2D or 
3D mammograms, breast ultrasounds, 
breast magnetic resonance imaging, or 
other technologies (as determined in ac-
cordance with such applicable criteria or 
guidelines); and 
‘‘(II) with respect to an individual 
who is not described in subclause (I) and 
who is determined by a health care pro-
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vider (in accordance with such most recent 
applicable criteria or guidelines) to require 
screening or diagnostic breast imaging by 
reason of factors, including age, race, eth-
nicity, or personal or family medical his-
tory, screening and diagnostic imaging 
(with no limitation applied on frequency) 
for the detection of breast cancer, includ-
ing 2D or 3D mammograms, breast 
ultrasounds, breast magnetic resonance im-
aging, or other technologies (as determined 
in accordance with such applicable criteria 
or guidelines); and’’. 
(2) APPLICATION OF NO COST-SHARING UNDER 
MEDICARE
ADVANTAGE
PLANS.—Section 
1852(a)(1)(B) of the Social Security Act (42 U.S.C. 
1395w–22(a)(1)(B)) is amended— 
(A) in clause (iv)— 
(i) by redesignating subclause (VIII) 
as subclause (IX); and 
(ii) inserting after subclause (VII) the 
following: 
‘‘(VIII) Beginning on January 1, 
2023, screening and diagnostic imag-
ing and other technologies described 
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in subclause (I) or (II) of section 
1861(ddd)(1)(B)(ii) furnished to an 
individual described in such subclause 
(I) or (II), respectively.’’; and 
(B) in clause (v), by striking ‘‘and (VI)’’ 
and inserting ‘‘(VI), and (VIII)’’. 
(c) COVERAGE UNDER MEDICAID.— 
(1) IN GENERAL.—Section 1905(a) of the So-
cial Security Act (42 U.S.C. 1396d(a)) is amend-
ed— 
(A) in paragraph (4)— 
(i) by striking ‘‘; and (D)’’ and insert-
ing ‘‘; (D)’’; 
(ii) by striking ‘‘; and (E)’’ and in-
serting ‘‘; (E)’’; 
(iii) by striking ‘‘; and (F)’’ and in-
serting ‘‘; (F)’’; and 
(iv) by inserting before the semicolon 
at the end the following: ‘‘; and (G)(i) with 
respect to an individual who is at increased 
risk of breast cancer (as determined in ac-
cordance with the most recent applicable 
American College of Radiology Appro-
priateness Criteria or the most recent ap-
plicable guidelines of the National Com-
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prehensive Cancer Network) or with het-
erogeneously or extremely dense breast tis-
sue (as defined by the Breast Imaging Re-
porting and Data System established by 
the American College of Radiology), in ad-
dition to any other item or service de-
scribed in this subsection, screening and 
diagnostic imaging (with no limitation ap-
plied on frequency) for the detection of 
breast cancer, including 2D or 3D mam-
mograms, breast ultrasounds, breast mag-
netic resonance imaging, or other tech-
nologies (as determined in accordance with 
such applicable criteria or guidelines); and 
(ii) with respect to an individual who is not 
described in clause (i) and who is deter-
mined by a health care provider (in accord-
ance with such most recent applicable cri-
teria or guidelines) to require screening or 
diagnostic breast imaging by reason of fac-
tors, including age, race, ethnicity, or per-
sonal or family medical history, screening 
and diagnostic imaging (with no limitation 
applied on frequency) for the detection of 
breast cancer, including 2D or 3D mam-
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mograms, breast ultrasounds, breast mag-
netic resonance imaging, or other tech-
nologies (as determined in accordance with 
such applicable criteria or guidelines)’’; 
and 
(B) in paragraph (13), in the matter pre-
ceding subparagraph (A), by inserting ‘‘(other 
than an item or service for which medical as-
sistance is provided pursuant to paragraph 
(4)(G))’’ after ‘‘services’’. 
(2) NO COST-SHARING FOR CERTAIN BREAST 
CANCER SCREENING AND DIAGNOSTIC IMAGING.— 
(A) IN GENERAL.—Subsections (a)(2) and 
(b)(2) of section 1916 of the Social Security 
Act (42 U.S.C. 1396o(a)(2)(D)) are each 
amended— 
(i) in the last subparagraph, by strik-
ing at the end ‘‘; and’’ and inserting ‘‘, 
or’’; and 
(ii) by adding at the end the following 
subparagraph: 
‘‘(K) with respect to an individual de-
scribed in clause (i) or (ii) of section 
1905(a)(4)(G), screening and diagnostic imag-
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ing and other technologies described in such 
clause (i) or (ii), respectively; and’’. 
(B) APPLICATION TO ALTERNATIVE COST- 
SHARING.—Section 1916A(b)(3)(B) of the So-
cial Security Act (42 U.S.C. 1396o–1(b)(3)(B)) 
is amended by adding at the end the following 
new clause: 
‘‘(xv) With respect to an individual 
described in clause (i) or (ii) of section 
1905(a)(4)(G), screening and diagnostic 
imaging and other technologies described 
in such clause (i) or (ii), respectively.’’. 
(3) INCLUSION
IN
BENCHMARK
COVERAGE.— 
Section 1937(b) of the Social Security Act (42 
U.S.C. 1396u–7(b)) is amended by adding at the 
end the following new paragraph: 
‘‘(9) COVERAGE OF CERTAIN BREAST CANCER 
SCREENING AND DIAGNOSTIC IMAGING FOR CERTAIN 
INDIVIDUALS.—Notwithstanding the previous provi-
sions of this section, a State may not provide for 
medical assistance through enrollment of an indi-
vidual with benchmark coverage or benchmark-equiv-
alent coverage under this section unless such cov-
erage includes medical assistance, with respect to an 
individual described in clause (i) or (ii) of section 
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1905(a)(4)(G), for screening and diagnostic imaging 
and other technologies described in such clause (i) or 
(ii), respectively.’’. 
(4) EFFECTIVE DATE.— 
(A) IN GENERAL.—Except as provided in 
subparagraph (B), the amendments made by 
this subsection shall take effect on January 1, 
2023. 
(B) DELAY PERMITTED IF STATE LEGISLA-
TION REQUIRED.—In the case of a State plan 
approved under title XIX of the Social Security 
Act which the Secretary of Health and Human 
Services determines requires State legislation 
(other than legislation appropriating funds) in 
order for the plan to meet the additional re-
quirements imposed by this section, the State 
plan shall not be regarded as failing to comply 
with the requirements of such title solely on the 
basis of the failure of the plan to meet such ad-
ditional requirements before the first day of the 
first calendar quarter beginning after the close 
of the first regular session of the State legisla-
ture that ends after the 1-year period beginning 
with the date of the enactment of this section. 
For purposes of the preceding sentence, in the 
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case of a State that has a 2-year legislative ses-
sion, each year of the session is deemed to be 
a separate regular session of the State legisla-
ture. 
(d) COVERAGE AND ELIMINATION OF COST-SHARING 
UNDER TRICARE.— 
(1) COVERAGE.—Title 10, United States Code, 
is amended— 
(A) in section 1074d(a), by adding at the 
end the following new paragraph: 
‘‘(3) Any member or former member of the uniformed 
services who is entitled to medical care under section 1074 
or 1074a of this title and is an individual described in 
subparagraph (B) of section 1079(a)(20) of this title shall 
also be entitled to the items and services described in sub-
paragraph (A) of such section (subject to the same limita-
tions specified in such subparagraph), as part of such 
medical care.’’; and 
(B) in section 1079(a), by adding at the 
end the following new paragraph: 
‘‘(20)(A) Screening and diagnostic imaging 
(with no limitation applied on frequency) for the de-
tection of breast cancer, including 2D or 3D mam-
mograms, breast ultrasounds, breast magnetic reso-
nance imaging, or other technologies (as determined 
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in accordance with the most recent applicable cri-
teria or guidelines described in subparagraph (B)), 
shall be provided if the patient is an individual de-
scribed in subparagraph (B). 
‘‘(B) An individual described in this subpara-
graph is— 
‘‘(i) an individual who is at increased risk 
of breast cancer (as determined in accordance 
with the most recent applicable American Col-
lege of Radiology Appropriateness Criteria or 
the most recent applicable guidelines of the Na-
tional Comprehensive Cancer Network) or with 
heterogeneously or extremely dense breast tis-
sue (as defined by the Breast Imaging Report-
ing and Data System established by the Amer-
ican College of Radiology); or 
‘‘(ii) an individual who is not described in 
clause (i) and who is determined by a health 
care provider (in accordance with such most re-
cent applicable criteria or guidelines) to require 
screening or diagnostic breast imaging by rea-
son of factors including age, race, ethnicity, or 
personal or family medical history.’’. 
(2) ELIMINATION
OF
COST-SHARING.—Such 
title is further amended— 
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(A) in section 1075a, by adding at the end 
the following new subsection: 
‘‘(d) ELIMINATION OF COST-SHARING FOR CERTAIN 
BREAST CANCER-RELATED ITEMS AND SERVICES.—Not-
withstanding any other provision under this section, cost- 
sharing may not be imposed or collected with respect to 
any beneficiary enrolled in TRICARE Prime for any item 
or service described in subparagraph (A) of section 
1079(a)(20) of this title provided under TRICARE Prime, 
in accordance with the limitations specified in such sub-
paragraph, if the beneficiary is an individual described in 
subparagraph (B) of such section.’’; 
(B) in section 1075(c), by adding at the 
end the following new paragraph: 
‘‘(4) Notwithstanding any other provision under 
this section, cost-sharing may not be imposed or col-
lected with respect to any beneficiary enrolled in 
TRICARE Select for any item or service described 
in subparagraph (A) of section 1079(a)(20) of this 
title provided under TRICARE Select, in accordance 
with the limitations specified in such subparagraph, 
if the beneficiary is an individual described in sub-
paragraph (B) of such section.’’; and 
(C) in section 1086(d)(3)— 
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(i) by redesignating subparagraph (C) 
as subparagraph (D); and 
(ii) by inserting after subparagraph 
(B) the following new subparagraph: 
‘‘(C) Notwithstanding any other provision under this 
section, cost-sharing may not be imposed or collected 
under subsection (a) with respect to any individual de-
scribed in subparagraph (B) of section 1079(a)(20) of this 
title for an item or service described in subparagraph (A) 
of such section and provided in accordance with the limita-
tions specified in such subparagraph.’’. 
(3) EFFECTIVE DATE.—The amendments made 
by this subsection shall take effect on January 1, 
2023. 
(e) COVERAGE AND ELIMINATION OF COST-SHARING 
WITH RESPECT TO VETERANS.— 
(1) COVERAGE
AND
ELIMINATION
OF
COST- 
SHARING.—Chapter 17 of title 38, United States 
Code, is amended by inserting after section 1720J 
the following new section (and conforming the table 
of sections at the beginning of such chapter accord-
ingly): 
‘‘§ 1720K. Breast screenings for certain individuals at 
increased risk for breast cancer 
‘‘(a) COVERAGE OF ITEMS AND SERVICES.— 
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