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A bill to require coverage for colorectal cancer screenings PDF

10 Pages·1999·0.44 MB·English
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Preview A bill to require coverage for colorectal cancer screenings

106thcongress H.R.1816 1stSessiox Torequirecoverageforcolorectalcancerscreenings. IN THE HOUSE OF REPRESENTATIVES May13,1999 Ms. Slaughter (for herself, Mrs. Morella, Mr. SlslSKi', and Mr. HastingsofFlorida) introduced thefollowingbill;wliichwasreferred to the Committeeon Commerce, and in addition tothe Committee on EducationandtheWorkforce,foraperiodtobesubsequentlydetermined bytheSpeaker,ineachcaseforconsiderationofsuchprovisionsasfall witliinthejurisdictionofthecommitteeconcerned A BILL Torequirecoverageforcolorectalcancerscreenings. 1 BeitenactedbytheSenateandHouseofRepresenta- 2 tivesoftheUnitedStatesofAmericainCongressassembled, 3 SECTION1.SHORTTITLE;FINDINGS. — 4 (a) Short Title. Tliis Act may be cited as the 5 "EliminateColorectalCancerActof1999". — 6 (b)FIXDIXGS. TheCongi-essfindsthefollowng: 7 (1) Colorectal cancer is the second leading 8 causeofcancerdeathsintheUnited Statesformen 9 andwomencombined. 2 1 (2) It is estimated that in 1999, 129,400 new 2 cases of colorectal cancer will be diagnosed in men 3 andwomenintheUnitedStates. 4 (3) Colorectal cancer is expected to kill 56,600 5 individualsintheUnitedStatesin1999. 6 (4) Research has shown that a liigh-fiber, low- 7 fat diet can significantly reduce the risk of devel- 8 opingcolorectalcancer. 9 (5) The adoption of a healthy diet at ayoung 10 age can significantly reduce the risk of developing 11 colorectalcancer. 12 (6) Appropriate screenings and regular tests 13 cansavelargenumbers oflivesbyleadingtoearlier 14 identificationofcolorectalcancer. 15 (7) The Centers for Disease Control and Pre- 16 vention, the Health Care FinancingAdministration, 17 andthe National CancerInstitutehaveinitiatedthe 18 Screen for Life Campaign targeted to uidi\iduals 19 age 50 and older to sjjread the message ofthe im- 20 portanceofcolorectalcancerscreeningtests. 21 (8) Education helps to inform the public of 22 symptomsfortheearlydetectionofcolorectalcancer 23 andmethodsofprevention. 24 SEC.2.COVERAGEFORCOLORECTALCANCERSCREENING. — 25 (a)GroupHetilthPlans. •HR1816m — 3 1 (1) Public health sEimcE act amend- 2 MENTS.—(A) Subpart 2 ofpartAoftitleXKVU of 3 thePublicHealth ServiceActisamendedbyadding 4 attheendthefollowingnewsection: 5 "SEC.2707.COVERAGEFORCOLORECTALCANCERSCREEN- 6 ING. 7 "(a) CoverageforColorectalCiVNCERScreen- — 8 l\g. — 9 "(1) Ingeneral. ^Agrouphealthplan, anda 10 health insurance issuer offering gi-oup health insur- 11 ance coverage, shaU pro\ade coverage for colorectal 12 cancerscreeningatregularintervalsto 13 "(A) any participant or beneficiary^ over 14 theageof50;and 15 "(B) any participant or beneficiary^ under 16 the age of 50 who is at a high risk for 17 colorectal cancer, or who may have symptoms 18 or circumstances that indicate a need for 19 colorectalcancerscreening. — 20 "(2)Deflnitionofhighrisk. Forpurposes 21 of subsection (a)(1)(B), the term 'liigh risk for 22 colorectal cancer' has the meaning given such term 23 insection 1861(pp)(2) oftheSocialSecurityAct(42 24 U.S.C. 1395x(pp)(2)). m •HR1816 4 — 1 ''(3) Method of screening. The group 2 healthplanorhealthinsuranceissuershallcoverthe 3 method andfrequencyofcolorectal cancer screening 4 deemed appropriate bya health care providertreat- 5 ing such participant or beneficiary, in consultation 6 with the participant or beneficiary. Such coverage 7 shall include the procedures in section 1861(pp)(l) 8 ofthe Social SecurityAct (42 U.S.C. 1395x(pp)(l)) 9 and section 4104(a)(2) ofthe Balanced BudgetAct 10 of1997. — 11 "(b) Notice. ^A group health planunderthis part 12 shall comply with the notice requirement under section 13 714(b) ofthe Employee Retirement Income SecurityAct 14 of 1974 with respect to the requirements ofthis section 15 asifsuchsectionappliedtosuchplan. 16 "(c) Non-Preemption of More Protectr^ 17 State Law With Respect to Health Insurance — 18 Issuers. This section shall not be construed to super- 19 sede anyprovision ofState lawwhich establishes, imple- 20 ments, orcontinuesineffectanystandardorrequirement 21 solely relatmg to health insurance issuers in connection 22 withgrouphealthinsurancecoveragethatpro\idesgreat- 23 er protections to participants and beneficiaries than the 24 protectionsprovidedunderthissection.". •HR1816ra — — 5 1 (B) Section 2723(c) of such Act (42 U.S.C. 2 300gg-23(c)) isamendedbystriking"section2704" 3 andinserting"sections2704and2707". 4 (2) ERISA AMENDMENTS.—(A) Subpart B of 5 part 7 of subtitle B oftitle I ofthe Employee Re- 6 tirementIncome SecurityActof1974isamendedby 7 addingattheendthefollowingnewsection: 8 "SEC.714.COVERAGEFORCOLORECTALCANCERSCREEN- 9 INC. 10 "(a) CoverageforColorectalCancerScreen- 11 ING. — 12 "(1) InGENT:ral. ^Agrouphealthplan, anda 13 health insurance issuer offering group health insur- 14 ance coverage, shall provide coverage for colorectal 15 cancerscreeningatregularintervalsto 16 "(A) any participant or benefician*?^ over 17 theageof50;and 18 "(B) any participant or beneficiary under 19 the age of 50 who is at a liigh risk for 20 colorectal cancer, or who may have sym])toms 21 or circumstances that indicate a need for 22 colorectalcancerscreening. — 23 "(2)DEFIN^TIONOFHIGHRISK. Forpurposes 24 of subsection (a)(1)(B), the term 'high risk for 25 colorectal cancer' has the meaning given such term •mi1816IH 6 1 insection 1861(pp)(2) oftheSocialSecurityAct (42 2 IJ.S.C. 1395x(pp)(2)). — 3 "(3) Method of screening. The group 4 healthplanorhealthinsuranceissuershallcoverthe 5 method and frequencyofcolorectal cancerscreening 6 deemed appropriatebya health care providertreat- 7 ing such participant or beneficiar}^, in consultation 8 with the participant or beneficiary. Such coverage 9 shaU include the procedures in section 1861(pp)(l) 10 ofthe Social SecurityAct (42 U.S.C. 1395x(pp)(l)) 11 and section 4104(a)(2) ofthe Balanced BudgetAct 12 of1997. — 13 "(b) Notice Under Group Health Plan. The 14 imposition of the requirements of this section shah be 15 treatedasamaterialmodificationinthetermsoftheplan 16 describedin section 102(a), forpurposes ofassuringno- 17 tice ofsuchrequirementsundertheplan; exceptthatthe 18 sunnnarv^ description required to be provided under the 19 tliirdtolastsentenceofsection 104(b)(1)withrespectto 20 such modification shall be providedbynot laterthan 60 21 days after the first day ofthe first plan year in wliich 22 suchrequirementsappty.". 23 (B) Section 731(c) of such Act (29 U.S.C. 24 1191(c)) is amended by striking "section 711" and 25 inserting"sections711and714". •HR1816IH 1 (C) Section 732(a) of such Act (29 U.S.C. 2 1191a(a))isamendedbystriking"section 711" and 3 inserting"sections 711 and714". 4 (D) The table ofcontents in section 1 ofsuch 5 Act is amended by inserting afterthe item relating 6 tosection713thefollowingnewitem: "Sec.714.Coverag^eforcolorectalcancerscreening.". — 7 (b) IxDmDUAL HeaIjTh Insurance. (1) Part B 8 oftitleXX\T;IofthePublicHealthServiceActisamend- 9 edbyinsertingafter section 2752 the followingnewsec- 10 tion: 11 "SEC.2753.COVERAGEFORCOLORECTALCANCERSCREEN- 12 INC. — 13 "(a) In Gen'ERAL. The provisions of section 14 2707(a) shall applyto health insurance coverage oftered 15 by a health insurance issuer in the individual market in 16 thesamemannerasitappUestohealthinsurancecoverage 17 offeredbyahealthinsurance issuerinconnectionwith a 18 grouphealthplaninthesmallorlargegroupmarket. — 19 "(b) Notice. ^Ahealth insurance issuerunderthis 20 part shall complywiththe notice requirementundersec- 21 tion 714(b) oftheEmployeeRetirementIncome Security 22 Act of1974withrespecttothe requirements referredto 23 insubsection (a) asifsuchsectionappliedto suchissuer 24 andsuchissuerwereagrouphealthplan.". •HR1816IH — 8 — 1 (c) Effectr^ Dates. (1)(A) Subjectto subpara- 2 graph (B), the amendmentsmadebysubsection (a) shall 3 applywith respect to group health plans for plan years 4 beginningonorafterJanuarj^1,2001. 5 (B) In the case of a group health plan maintained 6 pursuant to 1 or more collective bargaining agreements 7 between employee representatives and 1 ormore employ- 8 ers ratifiedbeforethe date ofenactmentofthisAct, the 9 amendments made by subsection (a) shall not apply to 10 planyearsbeginningbeforethelaterof 11 (i) the date on wliich the last collective bar- 12 gaming agreements relating to the plan termmates 13 (determinedwithout regardto anyextensionthereof 14 agreed to after the date of enactment ofthisAct), 15 or 16 (ii)January1, 2001. 17 Forpurposesofclause(i),anyplanamendmentmadepur- 18 suanttoa collectivebargainingagreementrelatingtothe 19 planwhich amendsthe plan solelyto conformto anyre- 20 quirementaddedbysubsection(a) shallnotbetreatedas 21 aterminationofsuchcollectivebargainingagreement. 22 (2) The amendments made by subsection (b) shall 23 applywith respect to health insurance coverage offered, 24 sold, issued, renewed, in effect, or operated in the indi- 25 vidualmarketonorafterJanuarj-^1,2001. >HR1816IH — 9 1 (3) The amendment made by subsection (e) shall 2 apply to contracts for contract periods be^miing on or 3 afterJanuar}^1,2001. — 4 (d) CoordinatedRegulations. TheSecretary-of 5 Labor andthe Secretary ofHealth and Human Services 6 shall ensure, through the execution of an interagency 7 memorandum ofunderstanding among such Secretaries, 8 that— 9 (1) regulations, ruhngs, and interpretations 10 issuedbysuchSecretariesrelatingtothesamemat- 11 ter over which both Secretaries have responsibility 12 undertheprovisions oftliissection (andtheamend- 13 mentsmadethereby) areadministeredso astohave 14 thesameeffectatalltimes;and 15 (2) coordination ofpohciesrelatingtoenforcing 16 the same requirements through such Secretaries in 17 order to have a coordinated enforcement strategy 18 that avoids duplication of enforcement efforts and 19 assignsprioritiesinenforcement. 20 SEC.3.SENSEOFTHECONGRESS. 21 ItisthesenseoftheCongressthat 22 (1) aUAmericans shouldbe educated aboutthe 23 risks, prevention, screening, and treatment of 24 colorectalcancer; >HR1816IH ensLIBRfllfV iiiiii'i'^^^iii 3 flDTS OD 1 (2)theCentersforDiseaseControlandPreven- 2 tion and the Department of Health and Human 3 Services should be commended for launching a co- 4 ordinatededucationcampaignoncolorectalcancerin 5 Marchof1999;and 6 (3)theCentersforDiseaseControlandPreven- 7 tion and the Department of Health and Human 8 Services should track the impact ofthe coordinated 9 education campaign on colorectal cancer and make 10 information on its progi-ess available to Members of 11 Congress. O « HR1816IH

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