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Bill > HB453

AL HB453

AL HB453
Breast cancer; to require coverage of breast reconstruction surgery

summary

Introduced
02/12/2026
In Committee
02/12/2026
Crossed Over
Passed
Dead

Introduced Session

2026 Regular Session

Bill Summary

Breast cancer; to require coverage of breast reconstruction surgery

AI Summary

This bill establishes new requirements for health insurance coverage related to breast reconstruction surgery in Alabama, effective October 1, 2026. It mandates that health benefit plans, which are any insurance policies or contracts providing health care services, must cover breast reconstruction, including all necessary procedures and services, regardless of whether the provider is in-network or out-of-network. The bill defines breast reconstruction broadly to encompass various surgical techniques, prostheses, and treatments for complications, aiming to ensure patient choice and access to comprehensive care. Insurers must respond to prior authorization requests within three business days and can only deny a specific reconstruction method if a qualified medical professional determines it's not medically necessary or doesn't meet prevailing medical standards, with specific appeal processes outlined. Furthermore, cost-sharing for breast reconstruction should not exceed in-network rates, and insurers cannot penalize or discourage enrollees from choosing out-of-network providers. The bill also extends these coverage requirements to the Public Education Employees' Health Insurance Plan and the State Employees' Health Insurance Plan, and mandates coverage through the Alabama Medicaid Agency, ensuring that women affected by breast cancer have access to reconstructive surgery as part of their recovery.

Committee Categories

Business and Industry

Sponsors (53)

Jennifer Fidler (R)*,  Ron Bolton (R),  Barbara Boyd (D),  Napoleon Bracy (D),  Bryan Brinyark (R),  Chip Brown (R),  Prince Chestnut (D),  Adline Clarke (D),  Terri Collins (R),  Kelvin Datcher (D),  Barbara Drummond (D),  Susan DuBose (R),  Brett Easterbrook (R),  Phillip Ensler (D),  Tracy Estes (R),  Bob Fincher (R),  Mark Gidley (R),  Juandalynn Givan (D),  Donna Givens (R),  Jeremy Gray (D),  Ben Harrison (R),  Rolanda Hollis (D),  Leigh Hulsey (R),  Steve Hurst (R),  Reed Ingram (R),  Thomas Jackson (D),  Bill Lamb (R),  Kelvin Lawrence (D),  James Lomax (R),  Penni McClammy (D),  Arnold Mooney (R),  Mary Moore (D),  Tashina Morris (D),  Cindy Myrex (R),  Kristin Pike Nelson (R),  Ed Oliver (R),  Kenneth Paschal (R),  Phillip Pettus (R),  Rex Reynolds (R),  Phillip Rigsby (R),  Chad Robertson (R),  Patrick Sellers (D),  Ginny Shaver (R),  Van Smith (R),  David Standridge (R),  Jerry Starnes (R),  Ontario Tillman (D),  Curtis Travis (D),  Allen Treadaway (R),  Pebblin Warren (D),  Margie Wilcox (R),  Randy Wood (R),  Ernie Yarbrough (R), 

Last Action

Pending House Insurance (on 02/12/2026)

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