section 2723(d)(1)) for a State that regulates such 
coverage, that requires coverage to be provided for 
annual screening mammography for women who are 
40 years of age or older and that provides at least 
the protections described in subsection (b). 
‘‘(2) CONSTRUCTION.—Section 2723(a)(1) shall 
not be construed as superseding a State law de-
scribed in paragraph (1).’’. 
(2) Section 2723(c) of such Act (42 U.S.C. 
300gg–23(c)) is amended by striking ‘‘section 2704’’ 
and inserting ‘‘sections 2704 and 2707’’. 
(b) ERISA AMENDMENTS.—
(1) Subpart B of part 7 of subtitle B of title 
I of the Employee Retirement Income Security Act 
of 1974 is amended by adding at the end the fol-
lowing new section: 
‘‘SEC. 714. STANDARDS RELATING TO BENEFITS FOR 
SCREENING MAMMOGRAPHY. 
‘‘(a) REQUIREMENTS FOR COVERAGE OF ANNUAL 
SCREENING MAMMOGRAPHY.—
‘‘(1) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group health insur-
ance coverage, that provides coverage for diagnostic 
mammography for any woman who is 40 years of 
age or older shall provide coverage for annual
screening mammography for such a woman under 
terms and conditions that are not less favorable than 
the terms and conditions for coverage of diagnostic 
mammography. 
‘‘(2) DIAGNOSTIC
AND
SCREENING
MAMMOG-
RAPHY DEFINED.—For purposes of this section—
‘‘(A) The term ‘diagnostic mammography’ 
means a radiologic procedure that is medically 
necessary for the purpose of diagnosing breast 
cancer and includes a physician’s interpretation 
of the results of the procedure. 
‘‘(B) The term ‘screening mammography’ 
means a radiologic procedure provided to a 
woman for the purpose of early detection of 
breast cancer and includes a physician’s inter-
pretation of the results of the procedure. 
‘‘(b) PROHIBITIONS.—A group health plan, and a 
health insurance issuer offering group health insurance 
coverage in connection with a group health plan, may 
not—
‘‘(1) deny coverage described in subsection 
(a)(1) on the basis that the coverage is not medically 
necessary or on the basis that the screening mam-
mography is not pursuant to a referral, consent, or 
recommendation by any health care provider;
‘‘(2) deny to a woman eligibility, or continued 
eligibility, to enroll or to renew coverage under the 
terms of the plan, solely for the purpose of avoiding 
the requirements of this section; 
‘‘(3) provide monetary payments or rebates to 
women to encourage such women to accept less than 
the minimum protections available under this sec-
tion; 
‘‘(4) penalize or otherwise reduce or limit the 
reimbursement of an attending provider because 
such provider provided care to an individual partici-
pant or beneficiary in accordance with this section; 
or 
‘‘(5) provide incentives (monetary or otherwise) 
to an attending provider to induce such provider to 
provide care to an individual participant or bene-
ficiary in a manner inconsistent with this section. 
‘‘(c) RULES OF CONSTRUCTION.—
‘‘(1) Nothing in this section shall be construed 
to require a woman who is a participant or bene-
ficiary to undergo annual screening mammography. 
‘‘(2) This section shall not apply with respect to 
any group health plan, or any group health insur-
ance coverage offered by a health insurance issuer,
which does not provide benefits for diagnostic mam-
mography. 
‘‘(3) Nothing in this section shall be construed 
as preventing a group health plan or issuer from im-
posing deductibles, coinsurance, or other cost-shar-
ing in relation to benefits for screening mammog-
raphy under the plan (or under health insurance 
coverage offered in connection with a group health 
plan), except that such coinsurance or other cost-
sharing for any portion may not be greater than 
such coinsurance or cost-sharing that is otherwise 
applicable with respect to benefits for diagnostic 
mammography. 
‘‘(4) Women between the ages of 40 and 49 
should (but are not required to) consult with appro-
priate health care practitioners before undergoing 
screening mammography, but nothing in this section 
shall be construed as requiring the approval of such 
a practitioner before undergoing an annual screening 
mammography. 
‘‘(d) NOTICE UNDER GROUP HEALTH PLAN.—The 
imposition of the requirements of this section shall be 
treated as a material modification in the terms of the plan 
described in section 102(a)(1), for purposes of assuring 
notice of such requirements under the plan; except that
the summary description required to be provided under the 
last sentence of section 104(b)(1) with respect to such 
modification shall be provided by not later than 60 days 
after the first day of the first plan year in which such 
requirements apply.
‘‘(e) LEVEL
AND TYPE
OF REIMBURSEMENTS.—
Nothing in this section shall be construed to prevent a 
group health plan or a health insurance issuer offering 
group health insurance coverage from negotiating the level 
and type of reimbursement with a provider for care pro-
vided in accordance with this section.
‘‘(f) PREEMPTION; EXCEPTION FOR HEALTH INSUR-
ANCE COVERAGE IN CERTAIN STATES.—
‘‘(1) IN GENERAL.—The requirements of this 
section shall not apply with respect to health insur-
ance coverage if there is a State law (as defined in 
section 731(d)(1)) for a State that regulates such 
coverage, that requires coverage to be provided for 
annual screening mammography for women who are 
40 years of age or older, and that provides at least 
the protections described in subsection (b). 
‘‘(2) CONSTRUCTION.—Section 731(a)(1) shall 
not be construed as superseding a State law de-
scribed in paragraph (1).’’.
(2) Section 731(c) of such Act (29 U.S.C. 
1191(c)) is amended by striking ‘‘section 711’’ and 
inserting ‘‘sections 711 and 714’’. 
(3) Section 732(a) of such Act (29 U.S.C. 
1191a(a)) is amended by striking ‘‘section 711’’ and 
inserting ‘‘sections 711 and 714’’. 
(4) The table of contents in section 1 of such 
Act is amended by inserting after the item relating 
to section 713 the following new item:
‘‘Sec. 714. Standards relating to benefits for screening mammography.’’.
(c) EFFECTIVE DATES.—(1) Subject to paragraph 
(2), the amendments made by this section shall apply with 
respect to group health plans (and health insurance cov-
erage offered in connection with group health plans) for 
plan years beginning on or after 1 year after the date of 
the enactment of this Act. 
(2) In the case of a group health plan maintained 
pursuant to 1 or more collective bargaining agreements 
between employee representatives and 1 or more employ-
ers ratified before the date of enactment of this Act, the 
amendments made by this section shall not apply to plan 
years beginning before the later of—
(A) the date on which the last collective bar-
gaining agreements relating to the plan terminates 
(determined without regard to any extension thereof