PRINTER'S NO. 1517
No. 1232 Session of 2007
INTRODUCED BY MENSCH, BARRAR, BELFANTI, BIANCUCCI, BISHOP,
CAUSER, CLYMER, COHEN, CREIGHTON, DALEY, EVERETT, FABRIZIO,
FAIRCHILD, FLECK, FREEMAN, GEORGE, GINGRICH, GOODMAN,
HALUSKA, HARPER, HERSHEY, HESS, HORNAMAN, JAMES, JOSEPHS,
KENNEY, KIRKLAND, KORTZ, KULA, MACKERETH, MAJOR, MARKOSEK,
McGEEHAN, McILHATTAN, MOYER, MURT, MUSTIO, PAYNE, PAYTON,
PETRONE, PHILLIPS, RAMALEY, RAYMOND, READSHAW, REED,
REICHLEY, RUBLEY, SABATINA, SAINATO, SANTONI, SCHRODER,
SOLOBAY, STERN, STURLA, SURRA, VEREB, VULAKOVICH, WALKO,
WANSACZ, WATSON, YOUNGBLOOD AND HENNESSEY, MAY 4, 2007
REFERRED TO COMMITTEE ON INSURANCE, MAY 4, 2007
AN ACT
1 Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
2 act relating to insurance; amending, revising, and
3 consolidating the law providing for the incorporation of
4 insurance companies, and the regulation, supervision, and
5 protection of home and foreign insurance companies, Lloyds
6 associations, reciprocal and inter-insurance exchanges, and
7 fire insurance rating bureaus, and the regulation and
8 supervision of insurance carried by such companies,
9 associations, and exchanges, including insurance carried by
10 the State Workmen's Insurance Fund; providing penalties; and
11 repealing existing laws," mandating health insurance coverage
12 for colorectal cancer screening.
13 The General Assembly of the Commonwealth of Pennsylvania
14 hereby enacts as follows:
15 Section 1. The act of May 17, 1921 (P.L.682, No.284), known
16 as The Insurance Company Law of 1921, is amended by adding a
17 section to read:
18 Section 635.2. Coverage for Colorectal Cancer Screening.--
19 (a) Except to the extent already covered under another policy,
1 all health insurance policies as defined in this section shall
2 also provide coverage for colorectal cancer screening for
3 covered individuals in accordance with the most recently
4 published American Cancer Society guidelines for colorectal
5 cancer screening and consistent with approved medical standards
6 and practices.
7 (1) Coverage for nonsymptomatic covered individuals who are
8 fifty (50) years of age or older shall include, but not be
9 limited to:
10 (i) an annual fecal occult blood test;
11 (ii) a sigmoidoscopy or a test consistent with approved
12 medical standards and practices to detect colon cancer, at least
13 once every four (4) years.
14 (iii) A colonoscopy at least once every ten (10) years.
15 (2) Coverage for symptomatic covered individuals who are
16 less than fifty (50) years of age shall include a colonoscopy,
17 sigmoidoscopy or any combination of colorectal cancer screening
18 tests at a frequency determined by a physician.
19 (b) The coverage required under this section shall be
20 subject to annual deductibles, coinsurance and copayment
21 requirements imposed by an entity subject to this section for
22 similar coverages under the same health insurance policy or
23 contract.
24 (c) For the purpose of this section:
25 (1) "Health insurance policy" means any individual or group
26 health, sickness or accident policy or subscriber contract or
27 certificate issued by an entity subject to any one of the
28 following:
29 (i) This act.
30 (ii) The act of December 29, 1972 (P.L.1701, No.364), known
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1 as the "Health Maintenance Organization Act."
2 (iii) The act of May 18, 1976 (P.L.123, No.54), known as the
3 "Individual Accident and Sickness Insurance Minimum Standards
4 Act."
5 (iv) Article XXIV, relating to fraternal benefit societies.
6 (v) 40 Pa.C.S. Ch. 61 (relating to hospital plan
7 corporations) or 63 (relating to professional health services
8 plan corporations).
9 (vi) Medical assistance.
10 The term does not include accident only, fixed indemnity,
11 limited benefit, credit, dental, vision, specified disease,
12 Medicare supplement, Civilian Health and Medical Program of the
13 Uniformed Services (CHAMPUS) supplement, long-term care or
14 disability income, workers' compensation or automobile medical
15 payment insurance.
16 (2) "Colonoscopy" means an examination of the rectum and the
17 entire colon using a lighted instrument called a colonoscope.
18 (3) "Colorectal cancer screening" means any of the following
19 procedures that are furnished to an individual for the purpose
20 of early detection of colorectal cancer:
21 (i) Screening fecal-occult blood test.
22 (ii) Screening flexible sigmoidoscopy.
23 (iii) Screening colonoscopy.
24 (iv) Screening barium enema.
25 (4) "Symptomatic person" means one of the following:
26 (i) an individual who experiences a change in bowel habits,
27 rectal bleeding or persistent stomach cramps, weight loss,
28 abdominal pain; or
29 (ii) an individual who poses a higher than average risk for
30 colorectal cancer because he or she has had colorectal cancer or
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1 polyps, inflammatory bowel disease or an immediate family
2 history of such conditions.
3 Section 2. This act shall take effect in 60 days.
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