This bill amends Florida Statutes to enhance insurance coverage for breast cancer screening and diagnosis, effective January 1, 2027. It mandates that health insurance policies provide minimum coverage for breast cancer screenings in accordance with the latest National Comprehensive Cancer Network guidelines. Key definitions are introduced, including "BI-RADS," "diagnostic breast examination," and "increased risk." The bill ensures that women at increased risk of breast cancer receive medically necessary screening mammograms and supplemental screenings without being subject to certain deductible or coinsurance provisions. Additionally, it clarifies coverage requirements for women with dense breast tissue and those who have completed breast cancer treatment, allowing for screenings regardless of a physician's prescription, as long as they are conducted in a registered facility.

The bill also revises existing statutes to align with the new coverage requirements, removing outdated provisions such as baseline mammograms for women aged 35-39 and biennial mammograms for women aged 40-49. It establishes that annual screening mammograms are required for women aged 40 and older, along with supplemental screenings for those at increased risk, based on criteria like genetic predisposition and family history. While coverage for these services is generally subject to standard deductible and coinsurance provisions, insurers must offer the option for coverage without these costs for an additional premium. The act is set to take effect on July 1, 2026.

Statutes affected:
S 1494 Filed: 627.6418, 627.6613, 641.31095