*SB0268.1*
January 13, 2022
SENATE BILL No. 268
_____
DIGEST OF SB 268 (Updated January 12, 2022 3:40 pm - DI 55)
Citations Affected: IC 27-8; IC 27-13.
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 (HMO) contracts. Defines "follow-up colonoscopy".
Provides that a policy of accident and sickness insurance or HMO
contract must cover: (1) a colorectal cancer screening test assigned
either an "A" or "B" grade by the United States Preventive Services
Task Force; and (2) A follow up colonoscopy if the result of a non-
invasive colorectal cancer screening test with an "A" or "B" grade from
the United States Preventive Services Task Force is positive. Provides
that a high deductible health plan may impose a deductible requirement
for a follow-up colonoscopy if these colorectal cancer screening
requirements would be inconsistent with Internal Revenue Code
provisions concerning high deductible health plans.
Effective: July 1, 2022.
Bohacek, Zay
January 10, 2022, read first time and referred to Committee on Insurance and Financial
Institutions.
January 12, 2022, amended, reported favorably — Do Pass.
SB 268—LS 6563/DI 137 January 13, 2022
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.
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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) As used in this section, "follow-up
4 colonoscopy" means a colonoscopy that is performed as a
5 follow-up to a colorectal cancer screening test, other than a
6 colonoscopy, that is assigned a grade of "A" or "B" by the United
7 States Preventive Services Task Force and for which the result was
8 positive.
9 (a) (b) Except as provided in subsection (d), (e), an insurer shall
10 provide coverage for colorectal cancer examinations and laboratory
11 tests for cancer for any nonsymptomatic insured in any accident and
12 sickness insurance policy that the insurer issues in Indiana or issues for
13 delivery in Indiana. Except as provided in subsection (f), covered
14 services must include:
15 (1) a colorectal cancer screening test assigned either an "A"
16 or "B" grade by the United States Preventive Services Task
17 Force; and
SB 268—LS 6563/DI 137 2
1 (2) a follow-up colonoscopy.
2 (b) (c) For an insured who is:
3 (1) at least forty-five (45) years of age; or
4 (2) less than forty-five (45) years of age and at high risk for
5 colorectal cancer;
6 the coverage required under this section must meet the requirements set
7 forth in subsection (c), (d), except as provided in subsection (e). (f).
8 (c) (d) An insured may not be required to pay an additional annual
9 deductible or coinsurance for the colorectal cancer examination and
10 laboratory testing benefit required by this section that is greater than an
11 annual deductible or coinsurance established for similar benefits under
12 the accident and sickness insurance policy under which the insured is
13 covered. If the accident and sickness insurance policy does not cover
14 a similar benefit, a deductible or coinsurance for the colorectal cancer
15 examination and laboratory testing benefit may not be set at a level that
16 materially diminishes the value of the colorectal cancer examination
17 and laboratory testing benefit.
18 (d) (e) In the case of an accident and sickness insurance policy that
19 is not employer based, the insurer shall offer to provide the coverage
20 described in this section.
21 (e) (f) The requirements imposed under this section do not apply to
22 A high deductible health plan, as defined by Section 223 of the Internal
23 Revenue Code, High deductible health plans described in this
24 subsection may not excuse may impose a deductible requirement with
25 respect to colorectal cancer screening in a manner for a follow-up
26 colonoscopy if the requirements imposed under subsection (b)(2)
27 would be inconsistent with Section 223(c)(2)(C) of the Internal
28 Revenue Code.
29 SECTION 2. IC 27-13-7-17, AS AMENDED BY P.L.36-2020,
30 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
31 JULY 1, 2022]: Sec. 17. (a) As used in this section, "colorectal cancer
32 testing" means examinations and laboratory tests for cancer for any
33 nonsymptomatic enrollee.
34 (b) As used in this section, "follow-up colonoscopy" means a
35 colonoscopy that is performed as a follow-up to a colorectal cancer
36 screening test, other than a colonoscopy, that is assigned a grade of
37 "A" or "B" by the United States Preventive Services Task Force
38 and for which the result was positive.
39 (b) (c) Except as provided in subsection (e), (f), a health
40 maintenance organization issued a certificate of authority in Indiana
41 shall provide colorectal cancer testing, including:
42 (1) a colorectal cancer screening test assigned either an "A"
SB 268—LS 6563/DI 137 3
1 or "B" grade by the United States Preventive Services Task
2 Force; and
3 (2) a follow-up colonoscopy.
4 as a covered service under every group contract that provides coverage
5 for basic health care services.
6 (c) (d) For an enrollee who is:
7 (1) at least forty-five (45) years of age; or
8 (2) less than forty-five (45) years of age and at high risk for
9 colorectal cancer;
10 the colorectal cancer testing required under this section must meet the
11 requirements set forth in subsection (d), (e), except as provided in
12 subsection (f). (g).
13 (d) (e) An enrollee may not be required to pay a copayment for the
14 colorectal cancer testing benefit required by this section that is greater
15 than a copayment established for similar benefits under the group
16 contract under which the enrollee is entitled to services. If the group
17 contract does not cover a similar covered service, the copayment for the
18 colorectal cancer testing benefit may not be set at a level that materially
19 diminishes the value of the colorectal cancer testing benefit.
20 (e) (f) In the case of coverage that is not employer based, the health
21 maintenance organization is required only to offer to provide colorectal
22 cancer testing as a covered service under a proposed group contract
23 providing coverage for basic health care services.
24 (f) (g) The requirements imposed under this section do not apply to
25 A high deductible health plan, as defined by Section 223 of the Internal
26 Revenue Code, High deductible health plans described in this
27 subsection may not excuse may impose a deductible requirement with
28 respect to colorectal cancer screening in a manner for a follow-up
29 colonoscopy if the requirements imposed under subsection (c)(2)
30 would be inconsistent with Section 223(c)(2)(C) of the Internal
31 Revenue Code.
SB 268—LS 6563/DI 137 4
COMMITTEE REPORT
Madam President: The Senate Committee on Insurance and
Financial Institutions, to which was referred Senate Bill No. 268, has
had the same under consideration and begs leave to report the same
back to the Senate with the recommendation that said bill be
AMENDED as follows:
Page 1, delete lines 1 through 17, begin a new paragraph and insert:
"SECTION 1. IC 27-8-14.8-3, AS AMENDED BY P.L.36-2020,
SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2022]: Sec. 3. (a) As used in this section, "follow-up
colonoscopy" means a colonoscopy that is performed as a
follow-up to a colorectal cancer screening test, other than a
colonoscopy, that is assigned a grade of "A" or "B" by the United
States Preventive Services Task Force and for which the result was
positive.
(a) (b) Except as provided in subsection (d), (e), an insurer shall
provide coverage for colorectal cancer examinations and laboratory
tests for cancer for any nonsymptomatic insured in any accident and
sickness insurance policy that the insurer issues in Indiana or issues for
delivery in Indiana. Except as provided in subsection (f), covered
services must include:
(1) a colorectal cancer screening test assigned either an "A"
or "B" grade by the United States Preventive Services Task
Force; and
(2) a follow-up colonoscopy.
(b) (c) For an insured who is:
(1) at least forty-five (45) years of age; or
(2) less than forty-five (45) years of age and at high risk for
colorectal cancer;
the coverage required under this section must meet the requirements set
forth in subsection (c), (d), except as provided in subsection (e). (f).
(c) (d) An insured may not be required to pay an additional annual
deductible or coinsurance for the colorectal cancer examination and
laboratory testing benefit required by this section that is greater than an
annual deductible or coinsurance established for similar benefits under
the accident and sickness insurance policy under which the insured is
covered. If the accident and sickness insurance policy does not cover
a similar benefit, a deductible or coinsurance for the colorectal cancer
examination and laboratory testing benefit may not be set at a level that
materially diminishes the value of the colorectal cancer examination
and laboratory testing benefit.
SB 268—LS 6563/DI 137 5
(d) (e) In the case of an accident and sickness insurance policy that
is not employer based, the insurer shall offer to provide the coverage
described in this section.
(e) (f) The requirements imposed under this section do not apply to
A high deductible health plan, as defined by Section 223 of the Internal
Revenue Code, High deductible health plans described in this
subsection may not excuse may impose a deductible requirement with
respect to colorectal cancer screening in a manner for a follow-up
colonoscopy if the requirements imposed under subsection (b)(2)
would be inconsistent with Section 223(c)(2)(C) of the Internal
Revenue Code.".
Page 2, delete lines 1 through 20.
Page 2, between lines 25 and 26, begin a new paragraph and insert:
"(b) As used in this section, "follow-up colonoscopy" means a
colonoscopy that is performed as a follow-up to a colorectal cancer
screening test, other than a colonoscopy, that is assigned a grade of
"A" or "B" by the United States Preventive Services Task Force
and for which the result was positive.".
Page 2, line 26, strike "(b)" and insert "(c)".
Page 2, line 26, strike "(e)," and insert "(f),".
Page 2, delete lines 29 through 33, begin a new line block indented
and insert:
"(1) a colorectal cancer screening test assigned either an "A"
or "B" grade by the United States Preventive Services Task
Force; and
(2) a follow-up colonoscopy.".
Page 2, delete lines 36 through 42, begin a new paragraph and
insert:
"(c) (d) For an enrollee who is:
(1) at least forty-five (45) years of age; or
(2) less than forty-five (45) years of age and at high risk for
colorectal cancer;
the colorectal cancer testing required under this section must meet the
requirements set forth in subsection (d), (e), except as provided in
subsection (f). (g).".
Page 3, line 1, strike "(d)" and insert "(e)".
Page 3, line 8, strike "(e)" and insert "(f)".
Page 3, delete lines 12 through 17, begin a new paragraph and
insert:
"(f) (g) The requirements imposed under this section do not apply
to A high deductible health plan, as defined by Section 223 of the
Internal Revenue Code, High deductible health plans described in this
SB 268—LS 6563/DI 137 6
subsection may not excuse may impose a deductible requirement with
respect to colorectal cancer screening in a manner for a follow-up
colonoscopy if the requirements imposed under subsection (c)(2)
would be inconsistent with Section 223(c)(2)(C) of the Internal
Revenue Code.".
and when so amended that said bill do pass.
(Reference is to SB 268 as introduced.)
ZAY, Chairperson
Committee Vote: Yeas 7, Nays 1.
SB 268—LS 6563/DI 137