A bill to require coverage for colorectal cancer screenings

10 Pages·1999·0.44 MB·English

by  United States. Congress. House

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.
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4 (a) Short Title. Tliis Act may be cited as the
5 "EliminateColorectalCancerActof1999".
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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.
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25 (a)GroupHetilthPlans.
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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-
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8 l\g.
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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.
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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)).
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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.
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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.".
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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.
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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.
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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
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6
1 insection 1861(pp)(2) oftheSocialSecurityAct (42
2 IJ.S.C. 1395x(pp)(2)).
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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.
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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".
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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.".
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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.
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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.
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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.".
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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.
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1 (3) The amendment made by subsection (e) shall
2 apply to contracts for contract periods be^miing on or
3 afterJanuar}^1,2001.
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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;
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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.
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