IN
Indiana Senate Bill SB0268

Indiana 2022 Regular Session

Indiana Senate Bill SB0268 Compare Versions

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1-*SB0268.1*
2-January 13, 2022
1+
2+Introduced Version
33 SENATE BILL No. 268
44 _____
5-DIGEST OF SB 268 (Updated January 12, 2022 3:40 pm - DI 55)
6-Citations Affected: IC 27-8; IC 27-13.
5+DIGEST OF INTRODUCED BILL
6+Citations Affected: IC 27-8-14.8-3; IC 27-13-7-17.
77 Synopsis: Colorectal cancer screening coverage. Specifies services to
88 be included as part of a covered colorectal cancer screening for policies
99 of accident and sickness insurance and health maintenance
10-organization (HMO) contracts. Defines "follow-up colonoscopy".
11-Provides that a policy of accident and sickness insurance or HMO
12-contract must cover: (1) a colorectal cancer screening test assigned
13-either an "A" or "B" grade by the United States Preventive Services
14-Task Force; and (2) A follow up colonoscopy if the result of a non-
15-invasive colorectal cancer screening test with an "A" or "B" grade from
16-the United States Preventive Services Task Force is positive. Provides
17-that a high deductible health plan may impose a deductible requirement
18-for a follow-up colonoscopy if these colorectal cancer screening
19-requirements would be inconsistent with Internal Revenue Code
20-provisions concerning high deductible health plans.
10+organization contracts. Removes the exception from coverage mandate
11+for high deductible health plans.
2112 Effective: July 1, 2022.
22-Bohacek, Zay
13+Bohacek
2314 January 10, 2022, read first time and referred to Committee on Insurance and Financial
2415 Institutions.
25-January 12, 2022, amended, reported favorably — Do Pass.
26-SB 268—LS 6563/DI 137 January 13, 2022
16+2022 IN 268—LS 6563/DI 137 Introduced
2717 Second Regular Session of the 122nd General Assembly (2022)
2818 PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
2919 Constitution) is being amended, the text of the existing provision will appear in this style type,
3020 additions will appear in this style type, and deletions will appear in this style type.
3121 Additions: Whenever a new statutory provision is being enacted (or a new constitutional
3222 provision adopted), the text of the new provision will appear in this style type. Also, the
3323 word NEW will appear in that style type in the introductory clause of each SECTION that adds
3424 a new provision to the Indiana Code or the Indiana Constitution.
3525 Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
3626 between statutes enacted by the 2021 Regular Session of the General Assembly.
3727 SENATE BILL No. 268
3828 A BILL FOR AN ACT to amend the Indiana Code concerning
3929 insurance.
4030 Be it enacted by the General Assembly of the State of Indiana:
4131 1 SECTION 1. IC 27-8-14.8-3, AS AMENDED BY P.L.36-2020,
4232 2 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
43-3 JULY 1, 2022]: Sec. 3. (a) As used in this section, "follow-up
44-4 colonoscopy" means a colonoscopy that is performed as a
45-5 follow-up to a colorectal cancer screening test, other than a
46-6 colonoscopy, that is assigned a grade of "A" or "B" by the United
47-7 States Preventive Services Task Force and for which the result was
48-8 positive.
49-9 (a) (b) Except as provided in subsection (d), (e), an insurer shall
50-10 provide coverage for colorectal cancer examinations and laboratory
51-11 tests for cancer for any nonsymptomatic insured in any accident and
52-12 sickness insurance policy that the insurer issues in Indiana or issues for
53-13 delivery in Indiana. Except as provided in subsection (f), covered
54-14 services must include:
55-15 (1) a colorectal cancer screening test assigned either an "A"
56-16 or "B" grade by the United States Preventive Services Task
57-17 Force; and
58-SB 268—LS 6563/DI 137 2
59-1 (2) a follow-up colonoscopy.
60-2 (b) (c) For an insured who is:
61-3 (1) at least forty-five (45) years of age; or
62-4 (2) less than forty-five (45) years of age and at high risk for
63-5 colorectal cancer;
64-6 the coverage required under this section must meet the requirements set
65-7 forth in subsection (c), (d), except as provided in subsection (e). (f).
66-8 (c) (d) An insured may not be required to pay an additional annual
67-9 deductible or coinsurance for the colorectal cancer examination and
68-10 laboratory testing benefit required by this section that is greater than an
69-11 annual deductible or coinsurance established for similar benefits under
70-12 the accident and sickness insurance policy under which the insured is
71-13 covered. If the accident and sickness insurance policy does not cover
72-14 a similar benefit, a deductible or coinsurance for the colorectal cancer
73-15 examination and laboratory testing benefit may not be set at a level that
74-16 materially diminishes the value of the colorectal cancer examination
75-17 and laboratory testing benefit.
76-18 (d) (e) In the case of an accident and sickness insurance policy that
77-19 is not employer based, the insurer shall offer to provide the coverage
78-20 described in this section.
79-21 (e) (f) The requirements imposed under this section do not apply to
80-22 A high deductible health plan, as defined by Section 223 of the Internal
81-23 Revenue Code, High deductible health plans described in this
82-24 subsection may not excuse may impose a deductible requirement with
83-25 respect to colorectal cancer screening in a manner for a follow-up
84-26 colonoscopy if the requirements imposed under subsection (b)(2)
85-27 would be inconsistent with Section 223(c)(2)(C) of the Internal
86-28 Revenue Code.
87-29 SECTION 2. IC 27-13-7-17, AS AMENDED BY P.L.36-2020,
88-30 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
89-31 JULY 1, 2022]: Sec. 17. (a) As used in this section, "colorectal cancer
90-32 testing" means examinations and laboratory tests for cancer for any
91-33 nonsymptomatic enrollee.
92-34 (b) As used in this section, "follow-up colonoscopy" means a
93-35 colonoscopy that is performed as a follow-up to a colorectal cancer
94-36 screening test, other than a colonoscopy, that is assigned a grade of
95-37 "A" or "B" by the United States Preventive Services Task Force
96-38 and for which the result was positive.
97-39 (b) (c) Except as provided in subsection (e), (f), a health
98-40 maintenance organization issued a certificate of authority in Indiana
99-41 shall provide colorectal cancer testing, including:
100-42 (1) a colorectal cancer screening test assigned either an "A"
101-SB 268—LS 6563/DI 137 3
102-1 or "B" grade by the United States Preventive Services Task
103-2 Force; and
104-3 (2) a follow-up colonoscopy.
105-4 as a covered service under every group contract that provides coverage
106-5 for basic health care services.
107-6 (c) (d) For an enrollee who is:
108-7 (1) at least forty-five (45) years of age; or
109-8 (2) less than forty-five (45) years of age and at high risk for
110-9 colorectal cancer;
111-10 the colorectal cancer testing required under this section must meet the
112-11 requirements set forth in subsection (d), (e), except as provided in
113-12 subsection (f). (g).
114-13 (d) (e) An enrollee may not be required to pay a copayment for the
115-14 colorectal cancer testing benefit required by this section that is greater
116-15 than a copayment established for similar benefits under the group
117-16 contract under which the enrollee is entitled to services. If the group
118-17 contract does not cover a similar covered service, the copayment for the
119-18 colorectal cancer testing benefit may not be set at a level that materially
120-19 diminishes the value of the colorectal cancer testing benefit.
121-20 (e) (f) In the case of coverage that is not employer based, the health
122-21 maintenance organization is required only to offer to provide colorectal
123-22 cancer testing as a covered service under a proposed group contract
124-23 providing coverage for basic health care services.
125-24 (f) (g) The requirements imposed under this section do not apply to
126-25 A high deductible health plan, as defined by Section 223 of the Internal
127-26 Revenue Code, High deductible health plans described in this
128-27 subsection may not excuse may impose a deductible requirement with
129-28 respect to colorectal cancer screening in a manner for a follow-up
130-29 colonoscopy if the requirements imposed under subsection (c)(2)
131-30 would be inconsistent with Section 223(c)(2)(C) of the Internal
132-31 Revenue Code.
133-SB 268—LS 6563/DI 137 4
134-COMMITTEE REPORT
135-Madam President: The Senate Committee on Insurance and
136-Financial Institutions, to which was referred Senate Bill No. 268, has
137-had the same under consideration and begs leave to report the same
138-back to the Senate with the recommendation that said bill be
139-AMENDED as follows:
140-Page 1, delete lines 1 through 17, begin a new paragraph and insert:
141-"SECTION 1. IC 27-8-14.8-3, AS AMENDED BY P.L.36-2020,
142-SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
143-JULY 1, 2022]: Sec. 3. (a) As used in this section, "follow-up
144-colonoscopy" means a colonoscopy that is performed as a
145-follow-up to a colorectal cancer screening test, other than a
146-colonoscopy, that is assigned a grade of "A" or "B" by the United
147-States Preventive Services Task Force and for which the result was
148-positive.
149-(a) (b) Except as provided in subsection (d), (e), an insurer shall
150-provide coverage for colorectal cancer examinations and laboratory
151-tests for cancer for any nonsymptomatic insured in any accident and
152-sickness insurance policy that the insurer issues in Indiana or issues for
153-delivery in Indiana. Except as provided in subsection (f), covered
154-services must include:
155-(1) a colorectal cancer screening test assigned either an "A"
156-or "B" grade by the United States Preventive Services Task
157-Force; and
158-(2) a follow-up colonoscopy.
159-(b) (c) For an insured who is:
160-(1) at least forty-five (45) years of age; or
161-(2) less than forty-five (45) years of age and at high risk for
162-colorectal cancer;
163-the coverage required under this section must meet the requirements set
164-forth in subsection (c), (d), except as provided in subsection (e). (f).
165-(c) (d) An insured may not be required to pay an additional annual
166-deductible or coinsurance for the colorectal cancer examination and
167-laboratory testing benefit required by this section that is greater than an
168-annual deductible or coinsurance established for similar benefits under
169-the accident and sickness insurance policy under which the insured is
170-covered. If the accident and sickness insurance policy does not cover
171-a similar benefit, a deductible or coinsurance for the colorectal cancer
172-examination and laboratory testing benefit may not be set at a level that
173-materially diminishes the value of the colorectal cancer examination
174-and laboratory testing benefit.
175-SB 268—LS 6563/DI 137 5
176-(d) (e) In the case of an accident and sickness insurance policy that
177-is not employer based, the insurer shall offer to provide the coverage
178-described in this section.
179-(e) (f) The requirements imposed under this section do not apply to
180-A high deductible health plan, as defined by Section 223 of the Internal
181-Revenue Code, High deductible health plans described in this
182-subsection may not excuse may impose a deductible requirement with
183-respect to colorectal cancer screening in a manner for a follow-up
184-colonoscopy if the requirements imposed under subsection (b)(2)
185-would be inconsistent with Section 223(c)(2)(C) of the Internal
186-Revenue Code.".
187-Page 2, delete lines 1 through 20.
188-Page 2, between lines 25 and 26, begin a new paragraph and insert:
189-"(b) As used in this section, "follow-up colonoscopy" means a
190-colonoscopy that is performed as a follow-up to a colorectal cancer
191-screening test, other than a colonoscopy, that is assigned a grade of
192-"A" or "B" by the United States Preventive Services Task Force
193-and for which the result was positive.".
194-Page 2, line 26, strike "(b)" and insert "(c)".
195-Page 2, line 26, strike "(e)," and insert "(f),".
196-Page 2, delete lines 29 through 33, begin a new line block indented
197-and insert:
198-"(1) a colorectal cancer screening test assigned either an "A"
199-or "B" grade by the United States Preventive Services Task
200-Force; and
201-(2) a follow-up colonoscopy.".
202-Page 2, delete lines 36 through 42, begin a new paragraph and
203-insert:
204-"(c) (d) For an enrollee who is:
205-(1) at least forty-five (45) years of age; or
206-(2) less than forty-five (45) years of age and at high risk for
207-colorectal cancer;
208-the colorectal cancer testing required under this section must meet the
209-requirements set forth in subsection (d), (e), except as provided in
210-subsection (f). (g).".
211-Page 3, line 1, strike "(d)" and insert "(e)".
212-Page 3, line 8, strike "(e)" and insert "(f)".
213-Page 3, delete lines 12 through 17, begin a new paragraph and
214-insert:
215-"(f) (g) The requirements imposed under this section do not apply
216-to A high deductible health plan, as defined by Section 223 of the
217-Internal Revenue Code, High deductible health plans described in this
218-SB 268—LS 6563/DI 137 6
219-subsection may not excuse may impose a deductible requirement with
220-respect to colorectal cancer screening in a manner for a follow-up
221-colonoscopy if the requirements imposed under subsection (c)(2)
222-would be inconsistent with Section 223(c)(2)(C) of the Internal
223-Revenue Code.".
224-and when so amended that said bill do pass.
225-(Reference is to SB 268 as introduced.)
226-ZAY, Chairperson
227-Committee Vote: Yeas 7, Nays 1.
228-SB 268—LS 6563/DI 137
33+3 JULY 1, 2022]: Sec. 3. (a) Except as provided in subsection (d), an
34+4 insurer shall provide coverage for colorectal cancer examinations and
35+5 laboratory tests for cancer for any nonsymptomatic insured in any
36+6 accident and sickness insurance policy that the insurer issues in Indiana
37+7 or issues for delivery in Indiana. Covered services must include:
38+8 (1) an initial colonoscopy or other medical test or procedure
39+9 for colorectal cancer screening; and
40+10 (2) if the results of a medical test or procedure other than a
41+11 colonoscopy under subdivision (1) are abnormal, a follow-up
42+12 colonoscopy.
43+13 (b) For an insured who is:
44+14 (1) at least forty-five (45) years of age; or
45+15 (2) less than forty-five (45) years of age and at high risk for
46+16 colorectal cancer;
47+17 the coverage required under this section must meet the requirements set
48+2022 IN 268—LS 6563/DI 137 2
49+1 forth in subsection (c). except as provided in subsection (e).
50+2 (c) An insured may not be required to pay an additional annual
51+3 deductible or coinsurance for the colorectal cancer examination and
52+4 laboratory testing benefit required by this section that is greater than an
53+5 annual deductible or coinsurance established for similar benefits under
54+6 the accident and sickness insurance policy under which the insured is
55+7 covered. If the accident and sickness insurance policy does not cover
56+8 a similar benefit, a deductible or coinsurance for the colorectal cancer
57+9 examination and laboratory testing benefit may not be set at a level that
58+10 materially diminishes the value of the colorectal cancer examination
59+11 and laboratory testing benefit.
60+12 (d) In the case of an accident and sickness insurance policy that is
61+13 not employer based, the insurer shall offer to provide the coverage
62+14 described in this section.
63+15 (e) The requirements imposed under this section do not apply to a
64+16 high deductible health plan, as defined by Section 223 of the Internal
65+17 Revenue Code. High deductible health plans described in this
66+18 subsection may not excuse a deductible requirement with respect to
67+19 colorectal cancer screening in a manner inconsistent with Section
68+20 223(c)(2)(C) of the Internal Revenue Code.
69+21 SECTION 2. IC 27-13-7-17, AS AMENDED BY P.L.36-2020,
70+22 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
71+23 JULY 1, 2022]: Sec. 17. (a) As used in this section, "colorectal cancer
72+24 testing" means examinations and laboratory tests for cancer for any
73+25 nonsymptomatic enrollee.
74+26 (b) Except as provided in subsection (e), a health maintenance
75+27 organization issued a certificate of authority in Indiana shall provide
76+28 colorectal cancer testing, including:
77+29 (1) an initial colonoscopy or other medical test or procedure
78+30 for colorectal cancer screening; and
79+31 (2) if the results of a medical test or procedure other than a
80+32 colonoscopy under subdivision (1) are abnormal, a follow-up
81+33 colonoscopy;
82+34 as a covered service under every group contract that provides coverage
83+35 for basic health care services.
84+36 (c) For an enrollee who is:
85+37 (1) at least forty-five (45) years of age; or
86+38 (2) less than forty-five (45) years of age and at high risk for
87+39 colorectal cancer;
88+40 the colorectal cancer testing required under this section must meet the
89+41 requirements set forth in subsection (d). except as provided in
90+42 subsection (f).
91+2022 IN 268—LS 6563/DI 137 3
92+1 (d) An enrollee may not be required to pay a copayment for the
93+2 colorectal cancer testing benefit required by this section that is greater
94+3 than a copayment established for similar benefits under the group
95+4 contract under which the enrollee is entitled to services. If the group
96+5 contract does not cover a similar covered service, the copayment for the
97+6 colorectal cancer testing benefit may not be set at a level that materially
98+7 diminishes the value of the colorectal cancer testing benefit.
99+8 (e) In the case of coverage that is not employer based, the health
100+9 maintenance organization is required only to offer to provide colorectal
101+10 cancer testing as a covered service under a proposed group contract
102+11 providing coverage for basic health care services.
103+12 (f) The requirements imposed under this section do not apply to a
104+13 high deductible health plan, as defined by Section 223 of the Internal
105+14 Revenue Code. High deductible health plans described in this
106+15 subsection may not excuse a deductible requirement with respect to
107+16 colorectal cancer screening in a manner inconsistent with Section
108+17 223(c)(2)(C) of the Internal Revenue Code.
109+2022 IN 268—LS 6563/DI 137