South Carolina H 3202: Diagnostic and supplemental breast examination insurance

Bill Text

2025-2026 Bill 3202 Text of Previous Version (Dec. 06, 2024) - South Carolina Legislature Online 

South Carolina General Assembly
126th Session, 2025-2026

Bill 3202

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 ADDING SECTION 
38-71-148 SO AS TO REQUIRE HEALTH INSURANCE POLICIES IN THIS STATE TO PROVIDE 
DIAGNOSTIC AND SUPPLEMENTAL BREAST EXAMINATIONS COVERAGE WITHOUT COST-SHARING 
REQUIREMENTS, TO DEFINE TERMS, TO PROVIDE EXCEPTIONS CONCERNING APPLICATION OF 
CERTAIN FEDERAL LAW, AND TO PROVIDE THESE PROVISIONS ARE IN ADDITION to OTHER 
EXISTING PROVISIONS CONCERNING HEALTH INSURANCE POLICY COVERAGE OF MAMMOGRAMS.

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

SECTION 1. Article 1, Chapter 71, Title 38 of the S.C. Code is 
amended by adding:

 Section 
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) 
All health insurance policies in this State may not impose any cost-sharing 
requirements on diagnostic breast examination and 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, 
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.

SECTION 2. This act takes effect upon approval 
by the Governor.

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This web page was last updated on December 06, 2024 at 10:56 AM