Senate Bill sb2880

    Florida Senate - 2004                                  SB 2880

    By Senator Wilson





    33-1486-04

  1                      A bill to be entitled

  2         An act relating to health insurance; creating

  3         s. 627.64194, F.S.; requiring health insurance

  4         to provide coverage for colorectal cancer

  5         examinations and laboratory tests; providing

  6         guidelines for such coverage and benefits;

  7         providing an effective date.

  8  

  9  Be It Enacted by the Legislature of the State of Florida:

10  

11         Section 1.  Section 627.64194, Florida Statutes, is

12  created to read:

13         627.64194  Colorectal cancer screening coverage.--

14         (1)  All individual and group health insurance policies

15  providing coverage on an expense-incurred basis, individual

16  and group service or indemnity type contracts issued by a

17  nonprofit corporation, individual and group service contracts

18  issued by a health maintenance organization, self-insured

19  group arrangements to the extent not preempted by federal law,

20  and managed health care delivery entities of any type or

21  description which are delivered, issued for delivery,

22  continued, or renewed on or after July 1, 2004, and which

23  provide coverage to any resident of this state shall provide

24  benefits or coverage for all colorectal cancer examinations

25  and laboratory tests specified in current American Cancer

26  Society guidelines for colorectal screening of asymptomatic

27  individuals. Benefits or coverage shall be provided for all

28  such colorectal screening examinations and tests that are

29  administered at a frequency identified in the current American

30  Cancer Society guidelines for colorectal cancer.

31  

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CODING: Words stricken are deletions; words underlined are additions.






    Florida Senate - 2004                                  SB 2880
    33-1486-04




 1         (2)  Benefits under this section shall be provided to a

 2  covered individual who is:

 3         (a)  At least 50 years of age; or

 4         (b)  Younger than 50 years of age and at high risk for

 5  colorectal cancer according to current colorectal cancer

 6  screening guidelines of the American Cancer Society.

 7         (3)  To encourage potentially lifesaving colorectal

 8  cancer screenings, patients and health care providers must not

 9  be required to meet burdensome criteria or overcome

10  significant obstacles to secure such coverage. An individual

11  may not be required to pay an additional deductible or

12  coinsurance for testing which is greater than an annual

13  deductible or coinsurance established for similar screening

14  benefits. If the program or contract does not cover a similar

15  benefit, a deductible or coinsurance may not be set at a level

16  that materially diminishes the value of the colorectal cancer

17  screening benefit required under this section.

18         (4)  Reimbursement to health care providers for

19  colorectal cancer screenings provided under this section must

20  be equal to or greater than the reimbursement to health care

21  providers provided under Title XVII of the Social Security

22  Act, relating to Medicare.

23         Section 2.  This act shall take effect July 1, 2004.

24  

25            *****************************************

26                          SENATE SUMMARY

27    Requires individual and group health insurance policies,
      service contracts, and other arrangements to provide
28    benefits for colorectal cancer examinations and
      laboratory tests for persons who meet specified criteria.
29    Provides standards for such examinations and tests.
      Prohibits certain actions by insurers which would have
30    the effect of diminishing the benefits of the coverage.

31  

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CODING: Words stricken are deletions; words underlined are additions.