S.B. No. 1747 aims to enhance coverage for screening mammograms, diagnostic imaging, and supplemental breast examinations under certain health benefit plans in Texas. The bill amends the Insurance Code by defining key terms such as "cost-sharing requirement," "diagnostic imaging," and "supplemental breast examination." Notably, it specifies that a health benefit plan cannot impose any cost-sharing requirements for these services, ensuring that individuals can access necessary breast health screenings without financial barriers. The definitions provided align with guidelines from the National Comprehensive Cancer Network, emphasizing the importance of medically necessary examinations.

Additionally, the bill modifies existing coverage requirements to ensure that the coverage for these breast health services is not less favorable than that for other radiological examinations. It removes previous stipulations regarding dollar limits, deductibles, and coinsurance factors, thereby simplifying the coverage criteria. The provisions of this Act will apply to health benefit plans delivered, issued for delivery, or renewed on or after January 1, 2026, with an effective date of September 1, 2025. If a federal waiver is needed for implementation, the relevant state agency may delay the provision's implementation until such authorization is obtained.

Statutes affected:
Introduced: Insurance Code 1356.001, Insurance Code 1356.005 (Insurance Code 1356)