Massachusetts 2023-2024 Regular Session

Massachusetts House Bill H927 Compare Versions

Only one version of the bill is available at this time.

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1	1	1 of 1
2	2	HOUSE DOCKET, NO. 1725 FILED ON: 1/18/2023
3	3	HOUSE . . . . . . . . . . . . . . . No. 927
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	James Arciero
8	8	_________________
9	9	To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
10	10	Court assembled:
11	11	The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
12	12	An Act relative to colon cancer screening.
13	13	_______________
14	14	PETITION OF:
15	15	NAME:DISTRICT/ADDRESS :DATE ADDED:James Arciero2nd Middlesex1/17/2023Vanna Howard17th Middlesex1/30/2023Ryan Morell1/17/2023 1 of 6
16	16	HOUSE DOCKET, NO. 1725 FILED ON: 1/18/2023
17	17	HOUSE . . . . . . . . . . . . . . . No. 927
18	18	By Representative Arciero of Westford, a petition (accompanied by bill, House, No. 927) of
19	19	James Arciero, Vanna Howard and Ryan Morell relative to colon cancer screening. Financial
20	20	Services.
21	21	[SIMILAR MATTER FILED IN PREVIOUS SESSION
22	22	SEE HOUSE, NO. 4145 OF 2021-2022.]
23	23	The Commonwealth of Massachusetts
24	24	_______________
25	25	In the One Hundred and Ninety-Third General Court
26	26	(2023-2024)
27	27	_______________
28	28	An Act relative to colon cancer screening.
29	29	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
30	30	of the same, as follows:
31	31	1 SECTION 1. Chapter 32A of the General Laws is hereby amended by adding the
32	32	2following section:-
33	33	3 Section 31. (a) The commission shall provide to any active or retired employee of the
34	34	4commonwealth who is insured under the group insurance commission coverage, starting at 30
35	35	5years of age, for colorectal cancer screening as found medically necessary by the insured’s
36	36	6primary care physician, including: (i) Flexible sigmoidoscopy every 5 years; (ii) Flexible
37	37	7sigmoidoscopy every 10 years plus FIT every year; (iii) KRAS, BRAF, PIK3CA Array as
38	38	8frequent as medically necessary; (iv) FIT-DNA every year or every 3 years, as medically
39	39	9necessary; (v) FIT every year; (vi) HSgFOBT every year; (vii) CT colonography every 5 years;
40	40	10and (vii) colonoscopy every 5 or 10 years. For the purposes of this section the term 2 of 6
41	41	11“colonoscopy”, shall mean a colorectal cancer screening service procedure that enables a
42	42	12physician to examine visually the inside of a patient's entire colon and includes the concurrent
43	43	13removal of polyps or biopsy, or both.
44	44	14 (b) Colorectal cancer screening services pursuant to subsection (a) performed under
45	45	15contract with the commission shall not be subject to any co-payment, deductible, coinsurance or
46	46	16other cost-sharing requirement. In addition, an insured shall not be subject to any additional
47	47	17charge for any service associated with a procedure or test for colorectal cancer screening, which
48	48	18may include 1 or more of the following: (i) removal of tissue or other matter; (ii) laboratory
49	49	19services; (iii) physician services; (iv) facility use, regardless of whether such facility is a
50	50	20hospital; and (v) anesthesia.
51	51	21 SECTION 2. Chapter 118E of the General Laws is hereby amended by adding the
52	52	22following section:-
53	53	23 Section 80. The division and it’s contracted health insurers, health plans, health
54	54	24maintenance organizations, behavioral health management firms and third-party administrators
55	55	25under contract to a Medicaid managed care organization or primary care plan shall provide
56	56	26coverage, starting at age 30, for colorectal cancer screening as found medically necessary by the
57	57	27insured’s primary care physician, including: (i) Flexible sigmoidoscopy every 5 years; (ii)
58	58	28Flexible sigmoidoscopy every 10 years plus FIT every year; (iii) KRAS, BRAF, PIK3CA Array
59	59	29as frequent as medically necessary; (iv) FIT-DNA every year or every 3 years, as medically
60	60	30necessary; (v) FIT every year; (vi) HSgFOBT every year; (vii) CT colonography every 5 years;
61	61	31and (vii) colonoscopy every 5 or 10 years. For the purposes of this section the term
62	62	32“colonoscopy”, shall mean a colorectal cancer screening service procedure that enables a 3 of 6
63	63	33physician to examine visually the inside of a patient's entire colon and includes the concurrent
64	64	34removal of polyps or biopsy, or both.
65	65	35 (b) Colorectal cancer screening services pursuant to subsection (a) performed under this
66	66	36section shall not be subject to any co-payment, deductible, coinsurance or other cost-sharing
67	67	37requirement. In addition, an insured shall not be subject to any additional charge for any service
68	68	38associated with a procedure or test for colorectal cancer screening, which may include 1 or more
69	69	39of the following: (i) removal of tissue or other matter; (ii) laboratory services; (iii) physician
70	70	40services; (iv) facility use, regardless of whether such facility is a hospital; and (v) anesthesia.
71	71	41 SECTION 3. Chapter 175 of the General Laws is hereby amended by inserting after
72	72	42section 47NN the following section:-
73	73	43 Section 47OO. (a) Any policy of accident and sickness insurance issued pursuant to
74	74	44section 108, and any group blanket policy of accident and sickness insurance issued pursuant to
75	75	45section 110 that is delivered, issued or renewed by agreement within or without the
76	76	46commonwealth shall provide coverage, starting at 30 years of age, for colorectal cancer
77	77	47screening as found medically necessary by the insured’s primary care physician, including: (i)
78	78	48Flexible sigmoidoscopy every 5 years; (ii) Flexible sigmoidoscopy every 10 years plus FIT every
79	79	49year; (iii) KRAS, BRAF, PIK3CA Array as frequent as medically necessary; (iv) FIT-DNA
80	80	50every year or every 3 years, as medically necessary; (v) FIT every year; (vi) HSgFOBT every
81	81	51year; (vii) CT colonography every 5 years; and (viii) colonoscopy every 5 or 10 years. For the
82	82	52purposes of this section the term “colonoscopy”, shall mean a procedure that enables a physician
83	83	53to examine visually the inside of a patient's entire colon and includes the concurrent removal of
84	84	54polyps or biopsy, or both. 4 of 6
85	85	55 (b) Colorectal cancer screening services pursuant to subsection (a) performed under this
86	86	56section shall not be subject to any co-payment, deductible, coinsurance or other cost-sharing
87	87	57requirement. In addition, an insured shall not be subject to any additional charge for any service
88	88	58associated with a procedure or test for colorectal cancer screening, which may include 1 or more
89	89	59of the following: (i) removal of tissue or other matter; (ii) laboratory services; (iii) physician
90	90	60services; (iv) facility use, regardless of whether such facility is a hospital; and (v) anesthesia.
91	91	61 SECTION 4. Chapter 176A of the General Laws is hereby amended by inserting after
92	92	62section 8OO the following section:-
93	93	63 Section 8PP. (a) Any contract between a subscriber and the corporation under an
94	94	64individual or group hospital service plan which is delivered, issued or renewed within the
95	95	65commonwealth shall provide coverage, starting at 30 years of age, for colorectal cancer
96	96	66screening as found medically necessary by the insured’s primary care physician, including: (i)
97	97	67Flexible sigmoidoscopy every 5 years; (ii) Flexible sigmoidoscopy every 10 years plus FIT every
98	98	68year; (iii) KRAS, BRAF, PIK3CA Array as frequent as medically necessary; (iv) FIT-DNA
99	99	69every year or every 3 years, as medically necessary; (v) FIT every year; (vi) HSgFOBT every
100	100	70year; (vii) CT colonography every 5 years; and (viii) colonoscopy every 5 or 10 years. For the
101	101	71purposes of this section the term “colonoscopy”, shall mean a procedure that enables a physician
102	102	72to examine visually the inside of a patient's entire colon and includes the concurrent removal of
103	103	73polyps or biopsy, or both.
104	104	74 (b) Colorectal cancer screening services pursuant to subsection (a) performed under this
105	105	75section shall not be subject to any co-payment, deductible, coinsurance or other cost-sharing
106	106	76requirement. In addition, an insured shall not be subject to any additional charge for any service 5 of 6
107	107	77associated with a procedure or test for colorectal cancer screening, which may include 1 or more
108	108	78of the following: (i) removal of tissue or other matter; (ii) laboratory services; (iii) physician
109	109	79services; (iv) facility use, regardless of whether such facility is a hospital; and (v) anesthesia.
110	110	80 SECTION 5. Chapter 176B of the General Laws is hereby amended by inserting after
111	111	81section 4OO the following section:-
112	112	82 Section 4PP. (a) Any subscription certificate under an individual or group medical
113	113	83service agreement delivered, issued or renewed within the commonwealth shall provide
114	114	84coverage, starting at 30 years of age, for colorectal cancer screening as found medically
115	115	85necessary by the insured’s primary care physician, including: (i) Flexible sigmoidoscopy every 5
116	116	86years; (ii) Flexible sigmoidoscopy every 10 years plus FIT every year; (iii) KRAS, BRAF,
117	117	87PIK3CA Array as frequent as medically necessary; (iv) FIT-DNA every year or every 3 years, as
118	118	88medically necessary; (iv) FIT every year; (vi) HSgFOBT every year; (vii) CT colonography
119	119	89every 5 years; and (viii) colonoscopy every 5 or 10 years. For the purposes of this section the
120	120	90term “colonoscopy”, shall mean a procedure that enables a physician to examine visually the
121	121	91inside of a patient's entire colon and includes the concurrent removal of polyps or biopsy, or
122	122	92both.
123	123	93 (b) Colorectal cancer screening services pursuant to subsection (a) performed under this
124	124	94section shall not be subject to any co-payment, deductible, coinsurance or other cost-sharing
125	125	95requirement. In addition, an insured shall not be subject to any additional charge for any service
126	126	96associated with a procedure or test for colorectal cancer screening, which may include 1 or more
127	127	97of the following: (i) removal of tissue or other matter; (ii) laboratory services; (iii) physician
128	128	98services; (iv) facility use, regardless of whether such facility is a hospital; and (v) anesthesia. 6 of 6
129	129	99 SECTION 6. Chapter 176G of the General Laws is hereby amended by inserting after
130	130	100section 4GG the following section:-
131	131	101 Section 4HH. (a) An individual or group health maintenance contract that is issued or
132	132	102renewed shall provide coverage, starting at 30 years of age, for colorectal cancer screening as
133	133	103found medically necessary by the insured’s primary care physician, including: (i) Flexible
134	134	104sigmoidoscopy every 5 years; (ii) Flexible sigmoidoscopy every 10 years plus FIT every year;
135	135	105(iii) KRAS, BRAF, PIK3CA Array as frequent as medically necessary; (iv) FIT-DNA every year
136	136	106or every 3 years, as medically necessary; (v) FIT every year; (vi) HSgFOBT every year; (vii) CT
137	137	107colonography every 5 years; and (viii) colonoscopy every 5 or 10 years. For the purposes of this
138	138	108section the term “colonoscopy”, shall mean a procedure that enables a physician to examine
139	139	109visually the inside of a patient's entire colon and includes the concurrent removal of polyps or
140	140	110biopsy, or both.
141	141	111 (b) Colorectal cancer screening services pursuant to subsection (a) performed under this
142	142	112section shall not be subject to any co-payment, deductible, coinsurance or other cost-sharing
143	143	113requirement. In addition, an insured shall not be subject to any additional charge for any service
144	144	114associated with a procedure or test for colorectal cancer screening, which may include 1 or more
145	145	115of the following: (i) removal of tissue or other matter; (ii) laboratory services; (iii) physician
146	146	116services; (iv) facility use, regardless of whether such facility is a hospital; and (v) anesthesia.