SB 509: Insurance; certain health benefit policies to cover an annual chest imaging test for a covered person who has undergone a mastectomy or other cancer treatment; provide

Georgia already requires many health insurance plans to keep cost-sharing (deductibles, copays, coinsurance) for diagnostic and supplemental breast screening exams in line with what they charge for routine screening mammograms (O.C.G.A. § 33-24-59.32). This bill expands that law by adding a new requirement: health benefit policies that cover diagnostic breast exams must also cover an annual chest imaging test, and any further medically necessary and clinically appropriate chest imaging tests, for people who have undergone a mastectomy or other cancer treatment like chemotherapy or radiation therapy. The bill also broadens the definition of imaging covered under the law, adding a new term, 'chest imaging test,' that includes X-rays, ultrasounds, MRIs, PET scans, and CT scans of the chest, and adds a formal definition of 'mastectomy.' It also clarifies which insurance contracts count as a 'health benefit policy,' excluding certain limited-benefit and self-insured federal ERISA plans. The changes would take effect July 1, 2026, and apply to policies issued or renewed on or after that date.

• Requires health benefit policies that cover diagnostic breast exams to also cover an annual chest imaging test for people who had a mastectomy or other cancer treatment.
• Requires coverage of any additional chest imaging tests beyond the annual one if a doctor deems them medically necessary and clinically appropriate.
• Adds a new legal definition of 'chest imaging test' covering X-rays, ultrasounds, MRIs, PET scans, and CT scans of the chest.
• Adds a formal definition of 'mastectomy' as surgical removal of one or both breasts.
• Clarifies that the coverage rules do not apply to certain limited-benefit insurance policies or to self-insured plans governed by the federal ERISA law.
• Sets the changes to take effect July 1, 2026, applying to policies issued or renewed on or after that date.

Georgians enrolled in individual or group health benefit policies in the state, especially breast cancer survivors and others who have had a mastectomy or cancer treatment like chemotherapy or radiation. Health insurers, HMOs, preferred provider organizations, and the state employee and Medicaid-related health contracts referenced in the bill are also affected.

People who have had a mastectomy or cancer treatment often need ongoing chest imaging to monitor for recurrence. Under this bill, insurers covering diagnostic breast exams would have to pay for an annual chest scan and additional necessary scans, potentially reducing out-of-pocket costs and access barriers for cancer survivors in Georgia.

• Section 1 amends O.C.G.A. § 33-24-59.32 to add a new subsection (b.1) requiring coverage of an annual chest imaging test and additional medically necessary tests for those who had a mastectomy or cancer treatment.
• Section 1 defines 'chest imaging test' to include X-rays, ultrasounds, MRIs, PET scans, and CT scans of the chest.
• Section 1 adds a definition of 'mastectomy' as surgical removal of one or both breasts.
• Section 1 revises the definition of 'health benefit policy' to include state employee and indigent-care contracts but exclude limited-benefit policies and self-insured ERISA plans.
• Section 1 retains the existing rule that the Commissioner of Insurance must issue rules consistent with guidelines from professional medical organizations like the National Comprehensive Cancer Network.
• Section 2 sets the effective date as July 1, 2026, applying to policies issued, delivered, or renewed on or after that date.
• Section 3 repeals conflicting laws.

1. 2026-02-17Senate Read and Referred (Senado)
2. 2026-02-12Senate Hopper (Senado)

• Ricky Williams (R, SD-025)Patrocinador principal
• Max Burns (R, SD-023)
• Jason T. Dickerson (R, SD-021)
• Randy Robertson (R, SD-029)
• Frank Ginn (R, SD-047)
• Lee Anderson (R, SD-024)
• Billy Hickman (R, SD-004)
• John Albers (R, SD-056)
• Bo Hatchett (R, SD-050)
• Bill Cowsert (R, SD-046)
• Chuck Payne (R, SD-054)
• Brian Strickland (R, SD-042)
• Matt Brass (R, SD-006)
• Freddie Sims (D, SD-012)
• Nikki Merritt (D, SD-009)
• Donzella James (D, SD-028)
• Tonya Anderson (D, SD-043)
• Sally Harrell (D, SD-040)
• Kenya Wicks (D, SD-034)
• Nan Orrock (D, SD-036)
• Elena Parent (D, SD-044)
• Sonya Halpern (D, SD-039)

• health insurance coverage
• breast cancer
• cancer screening
• insurance mandates
• women's health