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 cancer 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 examinations 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 framework. The provisions of this Act will apply to health benefit plans delivered, issued, or renewed on or after January 1, 2026, with an effective date of September 1, 2025. If a federal waiver or authorization is needed for implementation, the relevant state agency may delay the implementation until such approval is obtained.

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