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SB177 ENGROSSED
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SB177
DGVISTN-2
By Senators Coleman-Madison, Figures, Smitherman, Beasley,
Coleman
RFD: Banking and Insurance
First Read: 20-Jan-26
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SB177 Engrossed
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First Read: 20-Jan-26
A BILL
TO BE ENTITLED
AN ACT
Relating to health insurance; to require that health
benefit plans offered in this state which pay or reimburse for
breast examinations, including mammography, provide the
coverage without imposing a deductible, copayment, or
coinsurance charge on the beneficiary.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. (a) For purposes of this section, the
following terms have the following meanings:
(1) COST-SHARING REQUIREMENT. A deductible, copayment,
coinsurance, or similar expense borne by the insured for a
covered benefit under a health benefit plan.
(2) DIAGNOSTIC BREAST EXAMINATION. A medically
necessary and appropriate examination of the breast by
technology that includes, but is not limited to,
contrast-enhanced mammography, diagnostic mammography, breast
magnetic resonance imaging, breast ultrasound, or molecular
breast imaging that is used to:
a. Evaluate an abnormality seen or suspected from a
screening examination for breast cancer; or
b. Evaluate an abnormality detected by another means of
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b. Evaluate an abnormality detected by another means of
examination.
(3) HEALTH BENEFIT PLAN. a. Any plan, policy, or
contract issued, delivered, or renewed in this state that
provides health coverage that includes payment for
hospitalization, physician care, treatment, surgery, therapy,
drugs, equipment, and any other medical expense, regardless of
the following:
1. Whether the plan, policy, or contract is provided by
a health care insurer; health maintenance organization
established under Chapter 21A of Title 27, Code of Alabama
1975; health care services plan established under Chapter 20
of Title 10A, Code of Alabama 1975; a nonprofit agricultural
organization that provides health benefits to its members
under Chapter 33 of Title 2, Code of Alabama 1975; or any
other entity that pays for, purchases, or reimburses for
health care services.
2. Whether the plan is for a group or an individual.
b. The term does not include accident-only, specified
disease, individual hospital indemnity, credit, dental-only,
Medicare supplement, long-term care, disability income, or
other limited benefit health insurance policies, or coverage
issued as supplemental to liability insurance, workers'
compensation, or automobile medical payment insurance.
(4) SUPPLEMENTAL BREAST EXAMINATION. A medically
necessary and appropriate examination of the breast that
includes, but is not limited to, contrast-enhanced
mammography, breast magnetic resonance imaging, breast
ultrasound, or molecular breast imaging that is used to screen
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ultrasound, or molecular breast imaging that is used to screen
for breast cancer when there is no abnormality seen or
suspected, based on personal or family medical history or
additional factors that increase the risk of breast cancer,
including dense tissue, on the recommendation of a physician.
(b) A health benefit plan that pays for, purchases, or
furnishes health care services to individuals who reside in
this state, and which provides coverage for a supplemental
breast examination or a diagnostic breast examination, may not
impose any cost-sharing requirement on an enrollee for a
supplemental breast examination or diagnostic breast
examination.
Section 2. This act shall become effective on January
1, 2027.
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1, 2027.
Senate
Read for the first time and referred
to the Senate committee on Banking
and Insurance
................20-Jan-26
Read for the second time and placed
on the calendar:
2 amendments
................05-Feb-26
Read for the third time and passed
as amended
Yeas 30
Nays 0
Abstains 1
................10-Feb-26
Patrick Harris,
Secretary.
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