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SB 158

Coverage for Diagnostic and Supplemental Breast Examinations

2025 Regular Session Introduced by Lori Berman

Florida law requires insurers to cover supplemental breast imaging for women with dense breast tissue at no out-of-pocket cost, expanding cancer screening access.

Chapter No. 2025-44
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Bill Summary · SB 158

Legislative bill overview

SB 158 requires health insurance plans in Florida to cover supplemental breast examinations, including supplemental screening mammography, tomosynthesis (3D mammography), ultrasound, and MRI, for women with dense breast tissue. The bill mandates coverage without cost-sharing (no copays, coinsurance, or deductibles) when ordered by a healthcare provider.

Why is this important

Dense breast tissue is present in approximately 40-50% of women and is associated with increased breast cancer risk and reduced mammography sensitivity. By requiring coverage of supplemental screening methods, the bill aims to improve early cancer detection for a significant portion of the female population. This addresses a coverage gap where many insurers previously limited or excluded supplemental imaging for dense breast screening.

Potential points of contention

  • Cost implications: Mandating comprehensive coverage of multiple imaging modalities without cost-sharing will increase insurance premiums and administrative costs, which may be passed to consumers or employers
  • Medical evidence debate: While dense breast tissue warrants additional screening, clinical guidelines vary on which supplemental imaging methods are most effective; some argue the bill's broad coverage mandate exceeds evidence-based recommendations
  • Insurance market effects: Smaller insurers and health plans may face disproportionate financial burden, potentially affecting market competition or coverage availability in rural areas

Compiled from official sources — confirm details with the bill’s official record.

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