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: Jan 20, 2022
BILL NUMBER: SB 268 BILL AMENDED: Jan 12, 2022
SUBJECT: Colorectal Cancer Screening Coverage.
FIRST AUTHOR: Sen. Bohacek BILL STATUS: As Passed Senate
FIRST SPONSOR: Rep. Carbaugh
FUNDS AFFECTED:XGENERAL IMPACT: State
DEDICATED
FEDERAL
Summary of Legislation: Colorectal Cancer Screening: 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 (HMO) contracts.
Definition: It defines "follow-up colonoscopy".
Follow-up Colonoscopy: The bill 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.
High Deductible Health Plan: The bill also 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 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
SB 268 1 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:
Explanation of Local Expenditures:
Explanation of Local Revenues:
State Agencies Affected: State Budget Agency; Department of Insurance; Family and Social Services
Administration.
Local Agencies Affected:
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