General Assembly Raised Bill No. 98
February Session, 2012 LCO No. 799
*00799_______INS*
Referred to Committee on Insurance and Real Estate
Introduced by:
(INS)
General Assembly
Raised Bill No. 98
February Session, 2012
LCO No. 799
*00799_______INS*
Referred to Committee on Insurance and Real Estate
Introduced by:
(INS)
AN ACT CONCERNING DEDUCTIBLES AND GUIDELINES FOR COLONOSCOPIES.
Be it enacted by the Senate and House of Representatives in General Assembly convened:
Section 1. Section 38a-492k of the 2012 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2013):
(a) Each individual health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, amended, renewed or continued in this state shall provide coverage for colorectal cancer screening, including, but not limited to, (1) an annual fecal occult blood test, and (2) colonoscopy, flexible sigmoidoscopy or radiologic imaging, in accordance with the recommendations established by the American College of Gastroenterology, [after consultation with] the American Cancer Society [and] or the American College of Radiology, based on the ages, family histories and frequencies provided in the recommendations. Except as specified in subsection (b) of this section, benefits under this section shall be subject to the same terms and conditions applicable to all other benefits under such policies.
(b) No such policy shall impose: [a]
(1) A deductible for a procedure that a physician initially undertakes as a screening colonoscopy or a screening sigmoidoscopy; or
(2) A coinsurance, copayment, deductible or other out-of-pocket expense for any additional colonoscopy ordered in a policy year by a physician for an insured. The provisions of this [subsection] subdivision shall not apply to a high deductible health plan as that term is used in subsection (f) of section 38a-493.
Sec. 2. Section 38a-518k of the 2012 supplement to the general statutes is repealed and the following is substituted in lieu thereof (Effective January 1, 2013):
(a) Each group health insurance policy providing coverage of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-469 delivered, issued for delivery, amended, renewed or continued in this state shall provide coverage for colorectal cancer screening, including, but not limited to, (1) an annual fecal occult blood test, and (2) colonoscopy, flexible sigmoidoscopy or radiologic imaging, in accordance with the recommendations established by the American College of Gastroenterology, [after consultation with] the American Cancer Society [and] or the American College of Radiology, based on the ages, family histories and frequencies provided in the recommendations. Except as specified in subsection (b) of this section, benefits under this section shall be subject to the same terms and conditions applicable to all other benefits under such policies.
(b) No such policy shall impose: [a]
(1) A deductible for a procedure that a physician initially undertakes as a screening colonoscopy or a screening sigmoidoscopy; or
(2) A coinsurance, copayment, deductible or other out-of-pocket expense for any additional colonoscopy ordered in a policy year by a physician for an insured. The provisions of this subsection shall not apply to a high deductible health plan as that term is used in subsection (f) of section 38a-520.
This act shall take effect as follows and shall amend the following sections:
Section 1 January 1, 2013 38a-492k
Sec. 2 January 1, 2013 38a-518k
This act shall take effect as follows and shall amend the following sections:
Section 1
January 1, 2013
38a-492k
Sec. 2
January 1, 2013
38a-518k
Statement of Purpose:
To prohibit insurers from imposing a deductible for a procedure that is initially undertaken as a screening colonoscopy or a screening sigmoidoscopy.
[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not underlined.]