LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
200 W. Washington St., Suite 301
Indianapolis, IN 46204
(317) 233-0696
iga.in.gov
FISCAL IMPACT STATEMENT
LS 6563 NOTE PREPARED: Dec 18, 2021
BILL NUMBER: SB 268 BILL AMENDED:
SUBJECT: Colorectal Cancer Screening Coverage.
FIRST AUTHOR: Sen. Bohacek BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
DEDICATED
FEDERAL
Summary of Legislation: The bill 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. It
removes the exception from coverage mandate for high deductible health plans.
Effective Date: July 1, 2022.
Explanation of State Expenditures: Indiana’s essential health benefits (EHB) benchmark plan includes
preventative care services without deductible contribution for nonsymptomatic adults or adults without
medical history of the disease. If a colonoscopy after another colorectal cancer screening exceeds the EHB,
the state may be responsible for defrayment of costs to the insured or to qualified health plans on behalf of
the insured. The state identifies requirements that exceed the EHB within a federal framework, and the
qualified health plans determine the actuarially adjusted cost of providing the state mandated benefit.
Additional Information - The EHB are required for nongrandfathered and small group plans. One of the ten
EHB covers preventive and wellness services and chronic disease management. A benchmark plan is selected
to set the requirements of the EHB by the state, and Indiana’s plan for FY 2017 to FY 2023 is Anthem
Insurance Companies Inc. Legacy PPO, with a plan name of Blue 6.0 Blue Access PPO Option 14, Rx G.
Explanation of State Revenues: A high deductible health plan health savings account (HSA) may be
disqualified when the plan pays for medical costs before the insured’s deductible is met. However,
preventative care costs are an exception. If an HSA were to be disqualified because the colonoscopy after
another screening test is not considered preventative care by the federal Internal Revenue Service,
contributions to the HSA by both the employer and the employee would be subject to federal tax and may
increase state income tax collections.
SB 268 1 Explanation of Local Expenditures: Local units that provide high deductible health plans with HSAs may
have increased costs due to taxes.
Explanation of Local Revenues:
State Agencies Affected: State Budget Agency; Department of Insurance; Family and Social Services
Administration.
Local Agencies Affected: Local units with high deductible health plans.
Information Sources:
https://www.cms.gov/CCIIO/Resources/Data-Resources/Downloads/Updated-Indiana-Benchmark-Summ
ary.pdf; https://www.cms.gov/CCIIO/Resources/Data-Resources/ehb; https://www.irs.gov/publications/p969.
Fiscal Analyst: Karen Rossen, 317-234-2106.
SB 268 2