Massachusetts 2025-2026 Regular Session

Massachusetts House Bill H1169 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. 3540 FILED ON: 1/17/2025
3	3	HOUSE . . . . . . . . . . . . . . . No. 1169
4	4	The Commonwealth of Massachusetts
5	5	_________________
6	6	PRESENTED BY:
7	7	Colleen M. Garry
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 under the age of 50 years of age, prevalence, screening and
13	13	insurance coverage and care in the Commonwealth aka Martha's Bill.
14	14	_______________
15	15	PETITION OF:
16	16	NAME:DISTRICT/ADDRESS :DATE ADDED:Colleen M. Garry36th Middlesex1/17/2025 1 of 7
17	17	HOUSE DOCKET, NO. 3540 FILED ON: 1/17/2025
18	18	HOUSE . . . . . . . . . . . . . . . No. 1169
19	19	By Representative Garry of Dracut, a petition (accompanied by bill, House, No. 1169) of Colleen
20	20	M. Garry relative to colon cancer under the age of 50 years of age, prevalence, screening and
21	21	insurance coverage and care. Financial Services.
22	22	[SIMILAR MATTER FILED IN PREVIOUS SESSION
23	23	SEE HOUSE, NO. 1020 OF 2023-2024.]
24	24	The Commonwealth of Massachusetts
25	25	_______________
26	26	In the One Hundred and Ninety-Fourth General Court
27	27	(2025-2026)
28	28	_______________
29	29	An Act relative to colon cancer under the age of 50 years of age, prevalence, screening and
30	30	insurance coverage and care in the Commonwealth aka Martha's Bill.
31	31	Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
32	32	of the same, as follows:
33	33	1 SECTION 1. Chapter 32A of the General Laws, as appearing in the 2016 Official
34	34	2Edition, is hereby amended by inserting after section 17Q the following section:-
35	35	3 Section 17R. (a) The commission shall provide to any active or retired employee of the
36	36	4commonwealth starting at 45 years of age who is insured under the group insurance commission
37	37	5coverage for colorectal cancer screening as found medically necessary by the insured’s primary
38	38	6care physician, including: (i) Flexible sigmoidoscopy every 5 years; (ii) Flexible sigmoidoscopy
39	39	7every 10 years plus FIT every year; (iii) KRAS, BRAF, PIK3CA Array as frequent as medically
40	40	8necessary; (iv) FIT-DNA every year or every 3 years, as medically necessary; (v) FIT every
41	41	9year; (vi) HSgFOBT every year; (vii) CT colonography every 5 years; and (vii) colonoscopy 2 of 7
42	42	10every 5 or 10 years. For the purposes of this section the term “colonoscopy”, shall mean a
43	43	11colorectal cancer screening service procedure that enables a physician to examine visually the
44	44	12inside of a patient's entire colon and includes the concurrent removal of polyps or biopsy, or
45	45	13both.
46	46	14 (b) Colorectal cancer screening services pursuant to subsection (a) performed under
47	47	15contract with the commission shall not be subject to any co-payment, deductible, coinsurance or
48	48	16other cost-sharing requirement. In addition, an insured shall not be subject to any additional
49	49	17charge for any service associated with a procedure or test for colorectal cancer screening, which
50	50	18may include 1 or more of the following: (i) removal of tissue or other matter; (ii) laboratory
51	51	19services; (iii) physician services; (iv) facility use, regardless of whether such facility is a
52	52	20hospital; and (v) anesthesia.
53	53	21 SECTION 3. Chapter 175 of the General Laws, as so appearing, is hereby amended by
54	54	22inserting after section 47KK the following section:-
55	55	23 Section 47LL. (a) Any policy of accident and sickness insurance issued pursuant to
56	56	24section 108, and any group blanket policy of accident and sickness insurance issued pursuant to
57	57	25section 110 that is delivered, issued or renewed by agreement within or without the
58	58	26commonwealth shall provide coverage, starting at 45 years of age, for colorectal cancer
59	59	27screening as found medically necessary by the insured’s primary care physician, including: (i)
60	60	28Flexible sigmoidoscopy every 5 years; (ii) Flexible sigmoidoscopy every 10 years plus FIT every
61	61	29year; (iii) KRAS, BRAF, PIK3CA Array as frequent as medically necessary; (iv) FIT-DNA
62	62	30every year or every 3 years, as medically necessary; (v) FIT every year; (vi) HSgFOBT every
63	63	31year; (vii) CT colonography every 5 years; and (viii) colonoscopy every 5 or 10 years. For the 3 of 7
64	64	32purposes of this section the term “colonoscopy”, shall mean a procedure that enables a physician
65	65	33to examine visually the inside of a patient's entire colon and includes the concurrent removal of
66	66	34polyps or biopsy, or both.
67	67	35 (b) Colorectal cancer screening services pursuant to subsection (a) performed under this
68	68	36section shall not be subject to any co-payment, deductible, coinsurance or other cost-sharing
69	69	37requirement. In addition, an insured shall not be subject to any additional charge for any service
70	70	38associated with a procedure or test for colorectal cancer screening, which may include 1 or more
71	71	39of the following: (i) removal of tissue or other matter; (ii) laboratory services; (iii) physician
72	72	40services; (iv) facility use, regardless of whether such facility is a hospital; and (v) anesthesia.
73	73	41 SECTION 4. Chapter 176A of the General Laws, as so appearing, is hereby amended by
74	74	42inserting after section 8MM the following section:-
75	75	43 Section 8NN. (a) Any contract between a subscriber and the corporation under an
76	76	44individual or group hospital service plan which is delivered, issued or renewed within the
77	77	45commonwealth shall provide coverage, starting at 45 years of age, for colorectal cancer
78	78	46screening as found medically necessary by the insured’s primary care physician, including: (i)
79	79	47Flexible sigmoidoscopy every 5 years; (ii) Flexible sigmoidoscopy every 10 years plus FIT every
80	80	48year; (iii) KRAS, BRAF, PIK3CA Array as frequent as medically necessary; (iv) FIT-DNA
81	81	49every year or every 3 years, as medically necessary; (v) FIT every year; (vi) HSgFOBT every
82	82	50year; (vii) CT colonography every 5 years; and (viii) colonoscopy every 5 or 10 years. For the
83	83	51purposes of this section the term “colonoscopy”, shall mean a procedure that enables a physician
84	84	52to examine visually the inside of a patient's entire colon and includes the concurrent removal of
85	85	53polyps or biopsy, or both. 4 of 7
86	86	54 (b) Colorectal cancer screening services pursuant to subsection (a) performed under this
87	87	55section shall not be subject to any co-payment, deductible, coinsurance or other cost-sharing
88	88	56requirement. In addition, an insured shall not be subject to any additional charge for any service
89	89	57associated with a procedure or test for colorectal cancer screening, which may include 1 or more
90	90	58of the following: (i) removal of tissue or other matter; (ii) laboratory services; (iii) physician
91	91	59services; (iv) facility use, regardless of whether such facility is a hospital; and (v) anesthesia.
92	92	60 SECTION 5. Chapter 176B of the General Laws, as so appearing, is hereby amended by
93	93	61inserting after section 4MM the following section:-
94	94	62 Section 4NN. (a) Any subscription certificate under an individual or group medical
95	95	63service agreement delivered, issued or renewed within the commonwealth shall provide
96	96	64coverage, starting at 45 years of age, for colorectal cancer screening as found medically
97	97	65necessary by the insured’s primary care physician, including: (i) Flexible sigmoidoscopy every 5
98	98	66years; (ii) Flexible sigmoidoscopy every 10 years plus FIT every year; (iii) KRAS, BRAF,
99	99	67PIK3CA Array as frequent as medically necessary; (iv) FIT-DNA every year or every 3 years, as
100	100	68medically necessary; (iv) FIT every year; (vi) HSgFOBT every year; (vii) CT colonography
101	101	69every 5 years; and (viii) colonoscopy every 5 or 10 years. For the purposes of this section the
102	102	70term “colonoscopy”, shall mean a procedure that enables a physician to examine visually the
103	103	71inside of a patient's entire colon and includes the concurrent removal of polyps or biopsy, or
104	104	72both.
105	105	73 (b) Colorectal cancer screening services pursuant to subsection (a) performed under this
106	106	74section shall not be subject to any co-payment, deductible, coinsurance or other cost-sharing
107	107	75requirement. In addition, an insured shall not be subject to any additional charge for any service 5 of 7
108	108	76associated with a procedure or test for colorectal cancer screening, which may include 1 or more
109	109	77of the following: (i) removal of tissue or other matter; (ii) laboratory services; (iii) physician
110	110	78services; (iv) facility use, regardless of whether such facility is a hospital; and (v) anesthesia.
111	111	79 SECTION 6. Chapter 176G of the General Laws, as so appearing, is hereby amended by
112	112	80inserting after section 4EE the following section:-
113	113	81 Section 4FF. (a) An individual or group health maintenance contract that is issued or
114	114	82renewed shall provide coverage, starting at 45 years of age, for colorectal cancer screening as
115	115	83found medically necessary by the insured’s primary care physician, including: (i) Flexible
116	116	84sigmoidoscopy every 5 years; (ii) Flexible sigmoidoscopy every 10 years plus FIT every year;
117	117	85(iii) KRAS, BRAF, PIK3CA Array as frequent as medically necessary; (iv) FIT-DNA every year
118	118	86or every 3 years, as medically necessary; (v) FIT every year; (vi) HSgFOBT every year; (vii) CT
119	119	87colonography every 5 years; and (viii) colonoscopy every 5 or 10 years. For the purposes of this
120	120	88section the term “colonoscopy”, shall mean a procedure that enables a physician to examine
121	121	89visually the inside of a patient's entire colon and includes the concurrent removal of polyps or
122	122	90biopsy, or both.
123	123	91 (b) Colorectal cancer screening services pursuant to subsection (a) performed under this
124	124	92section shall not be subject to any co-payment, deductible, coinsurance or other cost-sharing
125	125	93requirement. In addition, an insured shall not be subject to any additional charge for any service
126	126	94associated with a procedure or test for colorectal cancer screening, which may include 1 or more
127	127	95of the following: (i) removal of tissue or other matter; (ii) laboratory services; (iii) physician
128	128	96services; (iv) facility use, regardless of whether such facility is a hospital; and (v) anesthesia.
129	129	97 SECTION 7. 6 of 7
130	130	98 Resolved, that a special commission, to consist of 13 members as follows: the secretary
131	131	99of the executive office of health and human services, or a designee; the commissioner of public
132	132	100health, or a designee; the commissioner of insurance, or a designee; and 10 members who shall
133	133	101be appointed as follows: 3 members appointed by the senate president, 1 of whom shall be the
134	134	102senate chairman of the joint committee on public health, or a designee, 1 of whom shall be a
135	135	103person with Colon Cancer under the age of 50 years old and 1 of whom is a medical specialist in
136	136	104Colon Cancer under the age of 50 years old ; 3 members appointed by the speaker of the house
137	137	105of representatives, 1 of whom shall be the house chairman of the joint committee on public
138	138	106health, or a designee, 1 of whom shall be a person with Colon Cancer under the age of 50 years
139	139	107old and 1 of whom is a medical specialist in Colon Cancer under the age of 50 years old ; and 4
140	140	108members appointed by the governor, 1 of whom shall be a person with Colon Cancer under the
141	141	109age of 50 years old , 1 of whom is a medical specialist in Colon Cancer under the age of 50 years
142	142	110old, and 2 members of the public with demonstrated expertise in issues relating to the work of
143	143	111the commission, is hereby established for the purpose of making an investigation and study to:
144	144	112 (1) establish a mechanism in order to ascertain the prevalence of Colon Cancer under the
145	145	113age of 50 years old in Massachusetts, and the unmet needs
146	146	114 of persons with Colon Cancer under the age of 50 years old and those of their families;
147	147	115collect time of diagnosis statistics and likely risks for Colon Cancer under the age of 50 years
148	148	116old;
149	149	117 (2) study Colon Cancer under the age of 50 years old prevention, screening, education
150	150	118and support programs for Colon Cancer under the age of 50 years old in the Commonwealth; 7 of 7
151	151	119 (3) provide recommendations for additional legislation, support programs and resources
152	152	120necessary to meet the unmet needs of persons with Colon Cancer under the age of 50 years old
153	153	121and their families and how to effectuate an early diagnosis and treatment for Colon Cancer under
154	154	122the age of 50 years old patients.
155	155	123 Vacancies in the membership of the commission shall be filled in the same manner
156	156	124provided for the original appointments.
157	157	125 The commission shall organize within 120 days following the appointment of a majority
158	158	126of its members and shall select a chairperson and vice-chairperson from among the members.
159	159	127The chairperson shall appoint a secretary who need not be a member of the commission.
160	160	128 The public members shall serve without compensation, but shall be reimbursed for
161	161	129necessary expenses incurred in the performance of their duties as provided by section 2A of
162	162	130chapter 4 of the General Laws.
163	163	131 The commission shall be entitled to call to its assistance and avail itself of the services of
164	164	132the employees of any state, county or municipal department, board, bureau, commission or
165	165	133agency as it may require and as may be available to it for its purposes.
166	166	134 The executive office of health and human services shall provide staff support to the
167	167	135commission.
168	168	136 The commission shall report to the general court the results of its investigation and study
169	169	137and its recommendations, if any, together with drafts of legislation necessary to carry its
170	170	138recommendations into effect, by filing the same with the clerk of the senate and the clerk of the
171	171	139House of representatives on or before December 31, 2023.