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 of diagnostic imaging and supplemental breast examinations are expanded to include various advanced imaging techniques and criteria for when these examinations are warranted.

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 also includes a provision that allows for the delay of implementation if a federal waiver or authorization is needed. The new regulations will apply to health benefit plans delivered, issued, or renewed on or after January 1, 2026, with the act taking effect on September 1, 2025.

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