BILL ANALYSIS

Senate Research Center	S.B. 1065
87R10402 MEW-F	By: Alvarado
	Business & Commerce
	4/12/2021
	As Filed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

Women with dense breast tissue, a strong family history of breast cancer, or a prior history of breast cancer often require a diagnostic examination to determine the presence of a cancerous tumor. Insurance coverage for diagnostic imaging procedures, such as ultrasound and magnetic resonance imaging, helps increase early detection, and potential successful treatment, for breast cancer.

S.B. 1065 seeks to increase the use of these examinations by requiring certain health benefit plans to provide favorable cost-sharing for certain diagnostic examinations that are no less favorable than the coverage provided for a screening mammogram.

As proposed, S.B. 1065 amends current law relating to coverage for diagnostic imaging for breast cancer under certain health benefit plans.

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends the heading to Chapter 1356, Insurance Code, to read as follows:

CHAPTER 1356. MAMMOGRAPHY AND OTHER BREAST IMAGING

SECTION 2. Amends Section 1356.001(1-a), Insurance Code, as follows:

(1-a) Defines "diagnostic imaging," rather than "diagnostic mammogram," to mean an imaging examination using mammography, ultrasound imaging, or magnetic resonance imaging that is designed to evaluate:

(A)-(C) makes no changes to these paragraphs; or

(D) an individual with a personal history of breast cancer or dense breast tissue.

SECTION 3. Amends Section 1356.005(a-1), Insurance Code, as follows:

(a-1) Requires that a health benefit plan that provides coverage for a screening mammogram provide coverage for diagnostic imaging, rather than a diagnostic mammogram, that is no less favorable than the coverage for a screening mammogram.

SECTION 4. Requires a state agency, if necessary for implementation of a provision of this Act, to request a waiver or authorization from a federal agency, and authorizes a delay of implementation until such a waiver or authorization is granted.

SECTION 5. Makes application of this Act prospective to January 1, 2022.

SECTION 6. Effective date: September 1, 2021.