HB 1112 expands insurance coverage for breast cancer screening and related follow-up care. The bill requires the state employee health plan, accident and sickness insurance policies, and health maintenance organization (HMO) contracts to cover diagnostic breast examinations and supplemental breast examinations, in addition to existing coverage for breast cancer screening mammography. It defines key terms such as diagnostic breast examination, supplemental breast examination, cost sharing requirements, and woman at risk, and it specifies that covered services include mammography, breast MRI, ultrasound, and other medically necessary evaluation methods.
The bill also sets age- and risk-based screening standards. It requires baseline mammography for certain individuals ages 35 to 39, annual mammography for women at risk under 40, and annual mammography for individuals 40 and older. Coverage must also include additional mammography views and medically necessary ultrasound services. For state employee plans and most private insurance/HMO coverage, the bill prohibits cost sharing for diagnostic breast examinations and supplemental breast examinations, and it generally bars less favorable deductibles, coinsurance, or similar limits than those applied to physical illness generally.
In state law, HB 1112 amends Indiana Code provisions governing the state employee health plan, accident and sickness insurance, and HMO coverage. It adds new statutory definitions and expands mandated benefits, while also requiring that these breast cancer services be covered in addition to benefits already provided for x-rays, laboratory testing, or wellness exams. The bill is set to take effect July 1, 2026, and would apply to policies and contracts issued or renewed on or after that date.
The overall sentiment reflected by the bill text is strongly supportive of expanded breast cancer screening access and reduced out-of-pocket costs. Because there are no committee transcripts or recorded votes provided, there is no direct evidence of opposition or support from legislators in the available context. The bill’s structure suggests a public-health and patient-access focus, particularly for women at elevated risk of breast cancer.
The main point of contention likely concerns the insurance mandate itself, especially the prohibition on cost sharing and the expanded coverage obligations for insurers, HMOs, and the state employee plan. Potential concerns could include increased premiums or plan costs, administrative complexity, and the scope of who qualifies as a woman at risk or for supplemental screening. The bill also distinguishes between employer-based and non-employer-based coverage, requiring insurers and HMOs to offer the coverage in some non-employer-based cases, which may raise implementation questions.
HB 1112 would amend Indiana insurance law and the state employee health plan statute to require coverage for diagnostic and supplemental breast examinations, along with specified mammography and related imaging services. It would also prohibit cost sharing for those services in most covered plans, affecting insurers, HMOs, state employee health coverage, and insured individuals who need breast cancer screening or follow-up care.
The bill appears to have a generally pro-access, pro-screening orientation, with the text emphasizing expanded coverage and elimination of cost sharing for medically necessary breast cancer examinations. No committee testimony or vote record was provided, so there is no documented opposition or bipartisan debate in the available materials.
The likely areas of contention are the insurance mandate and the cost implications for the state employee plan, insurers, and HMOs. Stakeholders concerned about premiums, benefit design, or administrative burden may object to the requirement that diagnostic and supplemental breast examinations be covered without cost sharing. Another possible issue is how broadly the bill defines risk-based screening eligibility and how insurers will determine medical necessity and compliance.