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2025-2026 Bill 820: Diagnostic and supplemental breast examination insurance - South Carolina Legislature Online
South Carolina General Assembly
126th Session, 2025-2026
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S. 820
STATUS INFORMATION
General Bill
Sponsors: Senator Devine
Document Path: SMIN-0109MW26.docx
Introduced in the Senate on January 15, 2026
Currently residing in the Senate Committee on
Banking and Insurance
Summary: Diagnostic and supplemental breast examination insurance
HISTORY OF LEGISLATIVE ACTIONS
Date
Body
Action Description with journal page number
1/15/2026
Senate
Introduced and read first time (
Senate Journal-page 5
)
1/15/2026
Senate
Referred to Committee on
Banking and Insurance
(
Senate Journal-page 5
)
View the latest
legislative information
at the website
VERSIONS OF THIS BILL
01/15/2026
A bill
TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY ADDING SECTION
38-71-148
SO AS TO DEFINE TERMS PERTAINING TO HEALTH INSURANCE AND BREAST
EXAMINATIONS; TO REQUIRE HEALTH INSURANCE POLICIES IN THIS STATE TO PROVIDE
DIAGNOSTIC AND SUPPLEMENTAL BREAST EXAMINATIONS COVERAGE WITHOUT COST-SHARING
REQUIREMENTS; TO PROVIDE EXCEPTIONS CONCERNING THE APPLICATION OF CERTAIN
FEDERAL LAWS; AND TO PROVIDE THAT THESE PROVISIONS ARE IN ADDITION TO OTHER
EXISTING PROVISIONS CONCERNING HEALTH INSURANCE POLICY COVERAGE OF MAMMOGRAMS.
B
e it enacted by the
General Assembly of the State of South Carolina:
S
ECTION 1.
A
rticle 1, Chapter 71, Title 38 of the S.C. Code is
amended by adding:
S
ection
38-71-148
.
(
A) For purposes of this
section:
(
1)
"Cost-sharing requirements" means a deductible, coinsurance, copayment, and any
maximum limitation on the application of such a deductible, coinsurance,
copayment, or similar out-of-pocket expense.
(
2)
"Diagnostic breast examinations" means a medically necessary and appropriate,
in accordance with the National Comprehensive Cancer Network Guidelines,
examination of the breast that:
(
a)
includes, but is not limited to, such examination using contrast-enhanced
mammography, diagnostic mammography, breast magnetic resonance imaging, breast
ultrasound, or molecular breast imaging; and
(
b)
is used to evaluate an abnormality:
(
i)
seen or suspected from a screening examination for breast cancer; or
(
ii) seen or detected by another
means of examination.
(
3)
"Health insurance policy" means a health benefit plan, contract, or evidence of
coverage providing health insurance coverage as defined in Section
38-71-670
(6)
and Section
38-71-840
(14).
(
4)
"Supplemental breast examination" means a medically necessary and appropriate,
in accordance with National Comprehensive Cancer Network Guidelines,
examination of the breast that:
(
a)
includes, but is not limited to, such examination using contrast-enhanced
mammography, breast magnetic resonance imaging, breast ultrasound, or molecular
breast imaging; and
(
b)
is used to screen for breast cancer:
(
i)
when there is no abnormality seen or suspected; but
(
ii) based on personal or family
medical history or additional factors, that increase the individual's risk of
breast cancer, such as heterogeneously or extremely dense breasts.
(
B) Health
insurance policies in this State may not impose any cost-sharing requirements
on diagnostic breast examination or supplemental breast examinations furnished
to an individual enrolled in the plan.
(
C)
If under federal law the application of subsection (B) would result in a Health
Savings Account ineligibility under Section 223 of the Internal Revenue Code, then
this requirement only applies for Health Savings Account-qualified high deductible
health plans with respect to the deductible of such a plan after the enrollee
has satisfied the minimum deductible under Section 223, except with respect to
items or services that are preventive care pursuant to Section 223(c)(2)(C) of
the federal Internal Revenue Code, in which case the requirements of subsection
(B) apply regardless of whether or not the minimum deductible under Section 223
has been satisfied.
(
D)
The provisions of this section are in addition to the provisions of Section
38-71-145
.
S
ECTION 2. This act takes effect upon approval
by the Governor.
----XX----
This web page was last updated on January 15, 2026 at 11:26 AM