State Group Insurance Program Coverage for Diagnostic and Supplemental Breast Examinations
Summary
HB 141 amends Florida’s state group insurance program laws to require coverage for diagnostic breast examinations and supplemental breast examinations without enrollee cost-sharing. The bill defines both terms in statute, tying them to medically necessary imaging services and to the most recent applicable guidelines of the National Comprehensive Cancer Network. Diagnostic breast examinations include imaging such as diagnostic mammography, breast MRI, or breast ultrasound used to evaluate an abnormality found or suspected during a screening exam. Supplemental breast examinations include MRI or ultrasound used to screen for breast cancer when no abnormality is suspected, but the person’s personal or family history or other risk factors indicate increased risk.
The bill also adds a new requirement to section 110.12303, Florida Statutes, stating that if a state employee health plan covers these breast examinations, the state group insurance program may not impose any enrollee cost-sharing liability. It includes an exception for health savings account-qualified high-deductible health plans to the extent needed to preserve federal tax treatment under Internal Revenue Code section 223, with special treatment for preventive care items and services. The act takes effect January 1, 2026.
Impact
HB 141 would change the state group insurance program by mandating first-dollar coverage for diagnostic and supplemental breast imaging for covered state employee health plans, eliminating copays, deductibles, coinsurance, or other enrollee cost-sharing for those services except where federal HSA rules require otherwise. It amends section 110.123, Florida Statutes, to add definitions for the covered breast examinations and amends section 110.12303 to impose the coverage requirement, affecting the benefits available to state employees and dependents enrolled in the state plan and the program’s contract terms with health insurers or administrators.
Sentiment
The available voting record shows strong and unanimous support at each committee stop, with 15-0 in the House Health Care Facilities & Systems Subcommittee, 29-0 in the House Budget Committee, and 24-0 in the House Health & Human Services Committee. No committee transcripts were provided, but the unanimous votes suggest broad bipartisan agreement and little visible opposition in committee.
Contention
No major contention is evident in the provided record. The only substantive policy limitation built into the bill is the federal-law carveout for health savings account-qualified high-deductible health plans, which preserves compliance with Internal Revenue Code section 223. Otherwise, the measure appears straightforward and noncontroversial, focused on removing out-of-pocket costs for breast cancer-related imaging in the state employee health plan.