Senate Bill #2317 (2020)

AN ACT RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

Prohibits cost sharing for persons forty-five (45) years or older for colorectal screening examinations, laboratory tests and colonoscopies covered by health insurance policies.

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Changes since original draft

  • 2020 – S 2317
  • 2020 – S 2317 SUBSTITUTE A AS AMENDED
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  • LC003657
  • LC003657/SUB A
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  • S T A T E O F R H O D E I S L A N D
  • IN GENERAL ASSEMBLY
  • JANUARY SESSION, A.D. 2020
  • S T A T E O F R H O D E I S L A N D
  • IN GENERAL ASSEMBLY
  • JANUARY SESSION, A.D. 2020
  • ____________
  • A N A C T
  • RELATING TO INSURANCE – ACCIDENT AND SICKNESS INSURANCE POLICIES
  • Introduced By: Senators Goodwin, Ruggerio, McCaffrey, Gallo, and Miller
  • Date Introduced: February 05, 2020
  • Referred To: Senate Health & Human Services
  • A N A C T
  • RELATING TO INSURANCE – ACCIDENT AND SICKNESS INSURANCEPOLICIES
  • Introduced By: Senators Goodwin, Ruggerio, McCaffrey, Gallo, and Miller
  • Date Introduced: February 05, 2020
  • Referred To: Senate Health & Human Services
  • It is enacted by the General Assembly as follows:
  • SECTION 1. Section 27-18-58 of the General Laws in Chapter 27-18 entitled "Accident and Sickness Insurance Policies" is hereby amended to read as follows:
  • 27-18-58. Prostate and colorectal examinations – Coverage mandated.
  • (a) Every individual or group hospital or accident and sickness insurance policy, medical expense insurance policy or individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state shall provide coverage for prostate and colorectal screening examinations and laboratory tests for cancer for any nonsymptomatic person covered under that policy or contract, in accordance with the current American Cancer Society guidelines. Provided, this section does not apply to insurance coverage providing benefits for: (1) hospital confinement indemnity; (2) disability income; (3) accident only; (4) long-term care; (5) Medicare supplement; (6) limited benefit health; (7) specific disease indemnity; (8) sickness or bodily injury or death by accident or both; and (9) other limited benefit policies.
  • (b) If an insured is forty-five (45) years of age or older, an insurer may not impose cost sharing on the coverage required by subsection (a) of this section and the coverage shall include, at a minimum:
  • (1) Fecal occult blood tests;
  • (2) Colonoscopies, including the removal of polyps during a screening procedure; or
  • (3) Double contrast barium enemas; and
  • (4) A colonoscopy, including the removal of polyps during the procedure, if the insured has a positive result on any fecal test.
  • (c) If an insured is at high risk for colorectal cancer, the coverage required by subsection (a) of this section shall include colorectal cancer screening examinations and laboratory tests as recommended by the treating physician.
  • (d) For the purposes of subsection (c) of this section, an individual is at high risk for colorectal cancer if the individual has:
  • (1) A family medical history of colorectal cancer;
  • (2) A prior occurrence of cancer or precursor neoplastic polyps;
  • (3) A prior occurrence of a chronic digestive disease condition such as inflammatory bowel disease, Crohn's disease or ulcerative colitis; or
  • (4) Other predisposing factors.
  • (e) Subsection (b)(4) of this section shall not apply to a high deductible health plan described in 26 U.S.C. 223.
  • SECTION 2. Section 27-19-49 of the General Laws in Chapter 27-19 entitled "Nonprofit Hospital Service Corporations" is hereby amended to read as follows:
  • 27-19-49. Prostate and colorectal examinations – Coverage mandated.
  • (a) Subscribers to any nonprofit hospital service corporation plan shall be afforded coverage under the plan for prostate and colorectal examinations and laboratory tests for cancer for any nonsymptomatic person covered under the policy or contract plan, in accordance with the current American Cancer Society guidelines.
  • (b) If an insured is forty-five (45) years of age or older, an insurer or the corporation may not impose cost sharing on the coverage required by subsection (a) of this section and the coverage shall include, at a minimum:
  • (1) Fecal occult blood tests;
  • (2) Colonoscopies, including the removal of polyps during a screening procedure; or
  • (3) Double contrast barium enemas; and
  • (4) A colonoscopy, including the removal of polyps during the procedure, if the insured has a positive result on any fecal test.
  • (c) If an insured is at high risk for colorectal cancer, the coverage required by subsection (a) of this section shall include colorectal cancer screening examinations and laboratory tests as recommended by the treating physician.
  • (d) For the purposes of subsection (c) of this section, an individual is at high risk for colorectal cancer if the individual has:
  • (1) A family medical history of colorectal cancer;
  • (2) A prior occurrence of cancer or precursor neoplastic polyps;
  • (3) A prior occurrence of a chronic digestive disease condition such as inflammatory bowel disease, Crohn's disease or ulcerative colitis; or
  • (4) Other predisposing factors.
  • (e) Subsection (b)(4) of this section does not apply to a high deductible health plan described in 26 U.S.C. 223.
  • SECTION 3. Section 27-20-44 of the General Laws in Chapter 27-20 entitled "Nonprofit Medical Service Corporations" is hereby amended to read as follows:
  • 27-20-44. Prostate and colorectal examinations – Coverage mandated.
  • (a) Subscribers to any nonprofit medical service corporation plan shall be afforded coverage under the plan for prostate and colorectal examinations and laboratory tests for cancer for any nonsymptomatic person covered under the policy or contract plan, in accordance with the current American Cancer Society guidelines.
  • (b) If an insured is forty-five (45) years of age or older, an insurer or the corporation may not impose cost sharing on the coverage required by subsection (a) of this section and the coverage shall include, at a minimum:
  • (1) Fecal occult blood tests;
  • (2) Colonoscopies, including the removal of polyps during a screening procedure; or
  • (3) Double contrast barium enemas; and
  • (4) A colonoscopy, including the removal of polyps during the procedure, if the insured has a positive result on any fecal test.
  • (c) If an insured is at high risk for colorectal cancer, the coverage required by subsection (a) of this section shall include colorectal cancer screening examinations and laboratory tests as recommended by the treating physician.
  • (d) For the purposes of subsection (c) of this section, an individual is at high risk for colorectal cancer if the individual has:
  • (1) A family medical history of colorectal cancer;
  • (2) A prior occurrence of cancer or precursor neoplastic polyps;
  • (3) A prior occurrence of a chronic digestive disease condition such as inflammatory bowel disease, Crohn's disease or ulcerative colitis; or
  • (4) Other predisposing factors.
  • (e) Subsection (b)(4) of this section does not apply to a high deductible health plan described in 26 U.S.C. 223.
  • SECTION 4. Section 27-41-60 of the General Laws in Chapter 27-41 entitled "Health Maintenance Organizations" is hereby amended to read as follows:
  • (a) Every individual or group hospital or accident and sickness insurance policy, medical expense insurance policy or individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state shall provide coverage for prostate and colorectal preventive screening examinations and laboratory tests for cancer for any nonsymptomatic person covered under that policy or contract, in accordance with the current AmericanCancerSocietyguidelines. Thecoverage required bythissectionshall include preventive colorectal cancer screening coverage for all colorectal cancer examinations and laboratory tests in accordance with AmericanCancer Society Guidelines, including for colorectal cancer screening of average risk individuals, including an initial colonoscopy or other medical test or procedure for colorectal cancer screening and a follow-up colonoscopy if the results of the initial medical test or procedure are abnormal. Provided, this section does not apply to insurance coverage providing benefits for: (1) hospital confinement indemnity; (2) disability income; (3) accident only; (4) long- term care; (5) Medicare supplement; (6) limited benefit health; (7) specific disease indemnity; (8) sickness or bodily injury or death by accident or both; and (9) other limited benefit policies.
  • (b) An insurer may not impose cost sharing on the coverage required by subsection (a) of this section when the services are delivered within the health insurer's provider network.
  • SECTION 2. Section 27-19-49 of the General Laws in Chapter 27-19 entitled "Nonprofit Hospital Service Corporations" is hereby amended to read as follows:
  • 27-19-49. Prostate and colorectal examinations – Coverage mandated.
  • (a) Subscribers to any nonprofit hospital service corporation plan shall be afforded coverage under the plan for prostate and colorectal examinationsand laboratory testsfor cancer for any nonsymptomatic person covered under the policy or plan contract, in accordance with the current American Cancer Society guidelines. The coverage required by this section shall include preventive colorectal cancer screening coverage for all colorectal cancer examinations and laboratory tests in accordance with American Cancer Society Guidelines, including for colorectal cancer screening of average risk individuals, including an initial colonoscopy or other medical test or procedure forcolorectal cancer screening and a follow-up colonoscopy if the resultsof the initial medical test or procedure are abnormal.
  • (b) An insurer or the corporation may not impose cost sharing on the coverage required by subsection (a) of this section when the services are delivered within the health insurer's provider network.
  • SECTION 3. Section 27-20-44 of the General Laws in Chapter 27-20 entitled "Nonprofit Medical Service Corporations" is hereby amended to read as follows:
  • 27-20-44. Prostate and colorectal examinations – Coverage mandated.
  • (a) Subscribers to any nonprofit medical service corporation plan shall be afforded coverage under the plan for prostate and colorectal examinationsand laboratory testsfor cancer for any nonsymptomatic person covered under the policy or plan contract, in accordance with the current American Cancer Society guidelines. The coverage required by this section shall include preventive colorectal cancer screening coverage for all colorectal cancer examinations and laboratory tests in accordance with American Cancer Society Guidelines, including for colorectal cancer screening of average risk individuals, including an initial colonoscopy or other medical test or procedure forcolorectal cancer screening and a follow-up colonoscopy if the resultsof the initial medical test or procedure are abnormal.
  • (b) An insurer or the corporation may not impose cost sharing on the coverage required by subsection (a) of this section when the services are delivered within the health insurer's provider network.
  • SECTION 4. Section 27-41-60 of the General Laws in Chapter 27-41 entitled "Health Maintenance Organizations" is hereby amended to read as follows:
  • 27-41-60. Prostate and colorectal examinations – Coverage mandated.
  • (a) Subscribers to any health maintenance organization plan shall be afforded coverage under that plan for prostate and colorectal examinations and laboratory tests for cancer for any nonsymptomatic person covered under the policy or contract plan, in accordance with the current American cancer society guidelines.
  • (b) If an insured is forty-five (45) years of age or older, an insurer or the organization may not impose cost sharing on the coverage required by subsection (a) of this section and the coverage shall include, at a minimum:
  • (1) Fecal occult blood tests;
  • (2) Colonoscopies, including the removal of polyps during a screening procedure; or
  • (3) Double contrast barium enemas; and
  • (4) A colonoscopy, including the removal of polyps during the procedure, if the insured has a positive result on any fecal test.
  • (c) If an insured is at high risk for colorectal cancer, the coverage required by subsection (a) of this section shall include colorectal cancer screening examinations and laboratory tests as recommended by the treating physician.
  • (d) For the purposes of subsection (c) of this section, an individual is at high risk for colorectal cancer if the individual has:
  • (1) A family medical history of colorectal cancer;
  • (2) A prior occurrence of cancer or precursor neoplastic polyps;
  • (3) A prior occurrence of a chronic digestive disease condition such as inflammatory bowel disease, Crohn's disease or ulcerative colitis; or
  • (4) Other predisposing factors.
  • (e) Subsection (b)(4) of this section does not apply to a high deductible health plan described in 26 U.S.C. 223.
  • SECTION 5. This act shall take effect upon passage and shall apply to policies or plans delivered, issued for delivery or renewed in this state on and after September 1, 2020.
  • (a) Subscribers to any health maintenance organization plan shall be afforded coverage under that plan for prostate and colorectal examinations and laboratory tests for cancer for any nonsymptomatic person covered under the policy or plan. contract, in accordance with the current American cancer society guidelines. The coverage required by thissection shall include preventive colorectal cancer screening coverage for all colorectal cancer examinations and laboratory tests in accordance with AmericanCancer Society Guidelines, including for colorectal cancer screening of average risk individuals, including an initial colonoscopy or other medical test or procedure for colorectal cancer screening and a follow-up colonoscopy if the results of the initial medical test or procedure are abnormal.
  • (b) An insurer or the organization may not impose cost sharing on the coverage required by subsection (a) ofthissection when the servicesare delivered withinthe health insurer'sprovider network.
  • SECTION 5. This act shall take effect upon passage and shall apply to policies or plans delivered, issued for delivery or renewed in this state on and after September 1, 2020 January 1, 2021.
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  • LC003657
  • LC003657/SUB A
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  • EXPLANATION
  • BY THE LEGISLATIVE COUNCIL
  • OF
  • EXPLANATION
  • BY THE LEGISLATIVE COUNCIL
  • OF
  • A N A C T
  • RELATING TO INSURANCE – ACCIDENT AND SICKNESS INSURANCE POLICIES
  • ***
  • This act would prohibit cost sharing for persons forty-five (45) years or older for colorectal screening examinations, laboratory tests and colonoscopies covered by health insurance policies or plans.
  • This act would take effect upon passage and would apply to policies or plans delivered, issued for delivery or renewed in this state on and after September 1, 2020. ======== LC003657 ========
  • RELATING TO INSURANCE – ACCIDENT AND SICKNESS INSURANCEPOLICIES
  • ***
  • This act would provide insurance coverage for certain prostate and colorectal preventive screening examinations and would prohibit cost sharing for persons related to colorectal screening examinations, laboratory tests, initial and follow-up colonoscopies covered by health insurance policies or plans.
  • This act would take effect upon passage and would apply to policies or plans delivered, issued for delivery or renewed in this state on and after September 1, 2020 January 1, 2021. ======== LC003657/SUB A ========

Votes

NOTE: Electronic voting records are unofficial and may not be accurate. For an official vote tally, check the House or Senate Journal from the day of the vote.

Floor vote for Approval of Amendment

July 16, 2020 at 5:58pm
Yeas: 36 / Nays: 1 / Not voting: 1 / Recused: 0
Legislator Vote
Sen. Algiere Y
Sen. Archambault Y
Sen. Bell N
Sen. Cano Y
Sen. Ciccone Y
Sen. Conley Y
Sen. Coyne Y
Sen. Crowley Y
Sen. Cruz NV
Sen. DiPalma Y
Sen. Euer Y
Sen. Felag Y
Sen. Gallo Y
Sen. Goldin Y
Sen. Goodwin Y
Sen. Lawson Y
Sen. Lombardi Y
Sen. Lombardo Y
Sen. Lynch Prata Y
Sen. McCaffrey Y
Sen. McKenney Y
Sen. Metts Y
Sen. Miller Y
Sen. Morgan Y
Sen. Murray Y
Sen. Nesselbush Y
Sen. Paolino Y
Sen. Pearson Y
Sen. Picard Y
Sen. Quezada Y
Sen. Raptakis Y
Sen. Rogers Y
Sen. Ruggerio Y
Sen. Satchell Y
Sen. Seveney Y
Sen. Sheehan Y
Sen. Sosnowski Y
Sen. Valverde Y

Floor vote for Passage as Amended

July 16, 2020 at 5:59pm
Yeas: 35 / Nays: 0 / Not voting: 3 / Recused: 0
Legislator Vote
Sen. Algiere Y
Sen. Archambault Y
Sen. Bell Y
Sen. Cano Y
Sen. Ciccone Y
Sen. Conley Y
Sen. Coyne Y
Sen. Crowley Y
Sen. Cruz NV
Sen. DiPalma Y
Sen. Euer Y
Sen. Felag Y
Sen. Gallo Y
Sen. Goldin Y
Sen. Goodwin Y
Sen. Lawson Y
Sen. Lombardi Y
Sen. Lombardo Y
Sen. Lynch Prata Y
Sen. McCaffrey Y
Sen. McKenney Y
Sen. Metts Y
Sen. Miller Y
Sen. Morgan Y
Sen. Murray Y
Sen. Nesselbush Y
Sen. Paolino Y
Sen. Pearson Y
Sen. Picard Y
Sen. Quezada Y
Sen. Raptakis Y
Sen. Rogers Y
Sen. Ruggerio Y
Sen. Satchell NV
Sen. Seveney Y
Sen. Sheehan NV
Sen. Sosnowski Y
Sen. Valverde Y