Introduced Version
SENATE BILL No. 268
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 27-8-14.8-3; IC 27-13-7-17.
Synopsis: Colorectal cancer screening coverage. Specifies services to
be included as part of a covered colorectal cancer screening for policies
of accident and sickness insurance and health maintenance
organization contracts. Removes the exception from coverage mandate
for high deductible health plans.
Effective: July 1, 2022.
Bohacek
January 10, 2022, read first time and referred to Committee on Insurance and Financial
Institutions.
2022 IN 268—LS 6563/DI 137 Introduced
Second Regular Session of the 122nd General Assembly (2022)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2021 Regular Session of the General Assembly.
SENATE BILL No. 268
A BILL FOR AN ACT to amend the Indiana Code concerning
insurance.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 27-8-14.8-3, AS AMENDED BY P.L.36-2020,
2 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2022]: Sec. 3. (a) Except as provided in subsection (d), an
4 insurer shall provide coverage for colorectal cancer examinations and
5 laboratory tests for cancer for any nonsymptomatic insured in any
6 accident and sickness insurance policy that the insurer issues in Indiana
7 or issues for delivery in Indiana. Covered services must include:
8 (1) an initial colonoscopy or other medical test or procedure
9 for colorectal cancer screening; and
10 (2) if the results of a medical test or procedure other than a
11 colonoscopy under subdivision (1) are abnormal, a follow-up
12 colonoscopy.
13 (b) For an insured who is:
14 (1) at least forty-five (45) years of age; or
15 (2) less than forty-five (45) years of age and at high risk for
16 colorectal cancer;
17 the coverage required under this section must meet the requirements set
2022 IN 268—LS 6563/DI 137 2
1 forth in subsection (c). except as provided in subsection (e).
2 (c) An insured may not be required to pay an additional annual
3 deductible or coinsurance for the colorectal cancer examination and
4 laboratory testing benefit required by this section that is greater than an
5 annual deductible or coinsurance established for similar benefits under
6 the accident and sickness insurance policy under which the insured is
7 covered. If the accident and sickness insurance policy does not cover
8 a similar benefit, a deductible or coinsurance for the colorectal cancer
9 examination and laboratory testing benefit may not be set at a level that
10 materially diminishes the value of the colorectal cancer examination
11 and laboratory testing benefit.
12 (d) In the case of an accident and sickness insurance policy that is
13 not employer based, the insurer shall offer to provide the coverage
14 described in this section.
15 (e) The requirements imposed under this section do not apply to a
16 high deductible health plan, as defined by Section 223 of the Internal
17 Revenue Code. High deductible health plans described in this
18 subsection may not excuse a deductible requirement with respect to
19 colorectal cancer screening in a manner inconsistent with Section
20 223(c)(2)(C) of the Internal Revenue Code.
21 SECTION 2. IC 27-13-7-17, AS AMENDED BY P.L.36-2020,
22 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
23 JULY 1, 2022]: Sec. 17. (a) As used in this section, "colorectal cancer
24 testing" means examinations and laboratory tests for cancer for any
25 nonsymptomatic enrollee.
26 (b) Except as provided in subsection (e), a health maintenance
27 organization issued a certificate of authority in Indiana shall provide
28 colorectal cancer testing, including:
29 (1) an initial colonoscopy or other medical test or procedure
30 for colorectal cancer screening; and
31 (2) if the results of a medical test or procedure other than a
32 colonoscopy under subdivision (1) are abnormal, a follow-up
33 colonoscopy;
34 as a covered service under every group contract that provides coverage
35 for basic health care services.
36 (c) For an enrollee who is:
37 (1) at least forty-five (45) years of age; or
38 (2) less than forty-five (45) years of age and at high risk for
39 colorectal cancer;
40 the colorectal cancer testing required under this section must meet the
41 requirements set forth in subsection (d). except as provided in
42 subsection (f).
2022 IN 268—LS 6563/DI 137 3
1 (d) An enrollee may not be required to pay a copayment for the
2 colorectal cancer testing benefit required by this section that is greater
3 than a copayment established for similar benefits under the group
4 contract under which the enrollee is entitled to services. If the group
5 contract does not cover a similar covered service, the copayment for the
6 colorectal cancer testing benefit may not be set at a level that materially
7 diminishes the value of the colorectal cancer testing benefit.
8 (e) In the case of coverage that is not employer based, the health
9 maintenance organization is required only to offer to provide colorectal
10 cancer testing as a covered service under a proposed group contract
11 providing coverage for basic health care services.
12 (f) The requirements imposed under this section do not apply to a
13 high deductible health plan, as defined by Section 223 of the Internal
14 Revenue Code. High deductible health plans described in this
15 subsection may not excuse a deductible requirement with respect to
16 colorectal cancer screening in a manner inconsistent with Section
17 223(c)(2)(C) of the Internal Revenue Code.
2022 IN 268—LS 6563/DI 137