Florida Senate - 2011 SB 350 By Senator Sobel 31-00382-11 2011350__ 1 A bill to be entitled 2 An act relating to insurance coverage for colorectal 3 cancer screening; providing legislative intent; 4 creating s. 627.64173, F.S.; requiring certain health 5 insurance policies, health maintenance organization 6 contracts, health insurance programs, group 7 arrangements, and managed health care delivery 8 entities providing coverage to state residents to 9 provide coverage for certain colorectal cancer 10 examinations and laboratory tests for colorectal 11 cancer; providing requirements; specifying covered 12 individuals; requiring coverage of certain evidence 13 based screening strategies; providing a definition; 14 prohibiting patients and providers from being required 15 to meet certain requirements to secure coverage; 16 prohibiting certain deductible or coinsurance 17 requirements; specifying absence of any requirement to 18 make nonparticipating provider referrals under certain 19 circumstances; providing for payment of 20 nonparticipating providers; excluding application to 21 certain insurance policies; providing an effective 22 date. 23 24 Be It Enacted by the Legislature of the State of Florida: 25 26 Section 1. It is the intent of the Legislature to help 27 reduce the state’s inordinately high cancer burden through early 28 detection and treatment of colorectal cancer by ensuring 29 coverage for the full range of colorectal cancer screenings, 30 including, but not limited to, colonoscopies, in health 31 insurance policies written in this state. 32 Section 2. Section 627.64173, Florida Statutes, is created 33 to read: 34 627.64173 Colorectal cancer screening coverage.— 35 (1) Any individual or group health insurance policy 36 providing coverage on an expense-incurred basis, any individual 37 or group service or indemnity type contract issued by a health 38 maintenance organization, any state medical assistance program 39 and its contracted insurers, whether providing services on a 40 managed care or fee-for-service basis, the state employees’ 41 health insurance program, any self-insured group arrangement to 42 the extent not preempted by federal law, or any managed health 43 care delivery entity of any type or description which is 44 delivered, issued for delivery, continued, or renewed on or 45 after January 1, 2012, and which provides coverage to any 46 resident of this state shall provide benefits or coverage for 47 all colorectal cancer examinations and laboratory tests 48 specified in subsection (2) for colorectal cancer. 49 (2) A colorectal screening examination and laboratory test 50 to be covered under this section must include, at a minimum: 51 (a) A fecal occult blood test conducted annually. 52 (b) A flexible sigmoidoscopy conducted every 5 years. 53 (c) A combination of a fecal occult blood test conducted 54 annually along with a flexible sigmoidoscopy conducted every 5 55 years. 56 (d) The screening contained in the guidelines from the 57 United States Preventive Services Task Force or a double 58 contrast barium enema every 5 years as an alternative when 59 indicated by a licensed physician. 60 (e) The screening contained in the guidelines from the 61 United States Preventive Services Task Force or a colonoscopy 62 every 10 years as an alternative when indicated by a licensed 63 physician. 64 (3) Benefits under this section shall be provided to a 65 covered individual who is: 66 (a) Fifty years of age or older; or 67 (b) Younger than 50 years of age and at high risk for 68 colorectal cancer. 69 (4) Any evidence-based screening strategy identified in 70 this section shall be covered by the insurer, with the choice of 71 strategy determined by the covered individual in consultation 72 with a licensed physician. 73 (5) For those individuals considered to be at average risk 74 for colorectal cancer, coverage or benefits shall be provided 75 for the choice of screening, if it is conducted in accordance 76 with the specified frequency prescribed in this section and, for 77 those individuals considered to be at high risk for colorectal 78 cancer, provided at a frequency deemed necessary by a licensed 79 physician. 80 (6) As used in this section, the term “individual at high 81 risk for colorectal cancer” means any individual who, because of 82 family history; prior experience of cancer or precursor 83 neoplastic polyps; a history of chronic digestive disease 84 condition, including inflammatory bowel disease, Crohn’s 85 disease, or ulcerative colitis; the presence of any appropriate 86 recognized gene markers for colorectal cancer; or other 87 predisposing factors, faces a higher than normal risk for 88 colorectal cancer. 89 (7) To encourage potentially lifesaving colorectal cancer 90 screenings, patients and health care providers may not be 91 required to meet burdensome criteria or overcome significant 92 obstacles to secure such coverage. An individual may not be 93 required to pay an additional deductible or coinsurance for 94 testing that is greater than an annual deductible or coinsurance 95 established for similar screening benefits. If the program or 96 contract does not cover a similar benefit, a deductible or 97 coinsurance may not be set at a level that materially diminishes 98 the value of colorectal cancer screening benefit required under 99 this section. 100 (8) A group health plan or health insurance issuer is not 101 required under this section to provide a referral to a 102 nonparticipating health care provider unless the plan or issuer 103 does not have an appropriate health care provider that is 104 available and accessible to administer the screening examination 105 and that is a participating health care provider with respect to 106 such treatment. 107 (9) If a plan or issuer refers an individual to a 108 nonparticipating health care provider under this section, 109 services provided as part of the approved screening examination 110 or resultant treatment shall be reimbursed as provided under the 111 policy or contract. 112 Section 3. This act does not apply to any insurance policy 113 that solely covers a specified accident, a specified disease, 114 disability income, Medicare supplement, or long-term care. 115 Section 4. This act shall take effect July 1, 2011.