South Carolina S 1019: PSA Screening

Bill Text

2025-2026 Bill 1019 Text of Previous Version (Mar. 17, 2026) - South Carolina Legislature Online 

South Carolina General Assembly
126th Session, 2025-2026

Bill 1019

Indicates Matter Stricken
Indicates New Matter

(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

A bill

TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY AMENDING 
SECTION 38-71-145, RELATING TO REQUIRED COVERAGE FOR MAMMOGRAMS, PAP SMEARS, 
AND PROSTATE CANCER EXAMINATIONS AND LIMITATIONS, SO AS TO DEFINE TERMS, 
REQUIRE HEALTH INSURANCE POLICIES IN THIS STATE TO ELIMINATE COST-SHARING 
REQUIREMENTS FOR PROSTATE CANCER EXAMINATIONS, SCREENINGS, AND DIAGNOSTIC 
LABORATORY, AND TO PROVIDE EXCEPTIONS CONCERNING THE APPLICATION OF CERTAIN 
FEDERAL LAW.

Be it enacted by the 
General Assembly of the State of South Carolina:

SECTION 1. Section 38-71-145 of the S.C. Code is amended to read:

 Section 
38-71-145. (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) "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).

 (3) "Mammogram" means a radiological 
examination of the breast for purposes of detecting breast cancer when 
performed as a result of a physician referral or by a health testing service 
which utilizes radiological equipment approved by the Department of Public 
Health, which examination may be made with the following minimum frequency:

 (a) once as a base-line mammogram for 
a female who is at least thirty-five years of age but less than forty years of 
age;

 (b) once every two years for a female 
who is at least forty years of age but less than fifty years of age;

 (c) once a year for a female who is at 
least fifty years of age; or

 (d) in accordance with the most recent 
published guidelines of the American Cancer Society.

 (4) "Pap smear" means an examination 
of the tissues of the cervix of the uterus for the purpose of detecting cancer 
when performed upon the recommendation of a medical doctor, which examination 
may be made once a year or more often if recommended by a medical doctor.

 (A)(B) All individual and group health insurance and health 
maintenance organization policies in this State shall include coverage in the 
policy for:

 (1) 
mammograms;

 (2) 
annual pap smears;

 (3) 
prostate cancer examinations, screenings, and laboratory work for diagnostic 
purposes in accordance with the most recent published guidelines of the American Cancer Society National 
Comprehensive Cancer Network.

 (B)(C) The coverage required to be offered under subsectionsubsections (A)(B)(1) and (B)(2) may not 
contain any exclusions, reductions, or other limitations as to coverages, 
deductibles, or coinsurance provisions which apply to that coverage unless 
these provisions apply generally to other similar benefits provided and paid 
for under the health insurance policy.

 (D) A health insurance policy in this 
State may not impose any cost-sharing requirements on prostate cancer 
examinations, screenings, and laboratory work for diagnostic purposes furnished 
to an individual enrolled in the plan under subsection (B)(3). If under federal 
law the application of subsection (C) 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 preventative care pursuant to Section 223(c)(2)(C) 
of the federal Internal Revenue Code, in which case the requirements of 
subsection (C) apply regardless of whether or not the minimum deductible under 
Section 223 has been satisfied.

 (C)(E) Nothing in this section prohibits a health insurance 
policy from providing benefits greater than those required to be offered by 
subsections (A)(B), and (B)(C), and (D) or more 
favorable to the enrollee than those required to be offered by subsections (A)(B), and 
(B)(C), and (D).

 (D)(F) This section applies to individual and group health 
insurance policies issued by a fraternal benefit society, an insurer, a health 
maintenance organization, or any similar entity, except as exempted by ERISA.

 (E) For purposes of this section:

 (1) "Mammogram" means a radiological 
examination of the breast for purposes of detecting breast cancer when 
performed as a result of a physician referral or by a health testing service 
which utilizes radiological equipment approved by the Department of Health and 
Environmental Control, which examination may be made with the following min