CORRECTIVE REPRINT
PRIOR PRINTER'S NOS. 1912, 1941 PRINTER'S NO. 1956
No. 1560 Session of 2001
INTRODUCED BY FEESE, COLAFELLA, HALUSKA, THOMAS, ADOLPH,
M. BAKER, BEBKO-JONES, BELARDI, BELFANTI, BLAUM, BOYES,
CALTAGIRONE, CAPPABIANCA, CAPPELLI, CAWLEY, CIVERA, CLYMER,
M. COHEN, COLEMAN, COSTA, COY, CREIGHTON, CRUZ, DALEY, DALLY,
DeLUCA, DERMODY, DiGIROLAMO, DONATUCCI, FAIRCHILD, FICHTER,
FLICK, FRANKEL, FREEMAN, GEIST, GEORGE, GODSHALL, GRUCELA,
HARHAI, HARPER, HASAY, HENNESSEY, HERMAN, HERSHEY, JAMES,
JOSEPHS, KELLER, KENNEY, KIRKLAND, KREBS, LaGROTTA, LAUGHLIN,
LESCOVITZ, LEWIS, MAJOR, MANDERINO, MARKOSEK, MARSICO,
McCALL, McGILL, McILHATTAN, MELIO, S. MILLER, NAILOR, NICKOL,
PALLONE, PERZEL, PHILLIPS, PIPPY, PISTELLA, PRESTON,
READSHAW, ROEBUCK, ROHRER, ROONEY, RUBLEY, SAINATO,
SAMUELSON, SANTONI, SATHER, SCHRODER, SEMMEL, SHANER, B.
SMITH, SOLOBAY, STABACK, STEELMAN, STETLER, T. STEVENSON,
STRITTMATTER, STURLA, SURRA, E. Z. TAYLOR, J. TAYLOR, TIGUE,
TRAVAGLIO, WALKO, WANSACZ, WASHINGTON, WATERS, WATSON, C.
WILLIAMS, J. WILLIAMS, WILT, WOJNAROSKI, YOUNGBLOOD, YUDICHAK
AND ZUG, MAY 9, 2001
REFERRED TO COMMITTEE ON INSURANCE, MAY 9, 2001
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:
1 Section 1. The act of May 17, 1921 (P.L.682, No.284), known
2 as The Insurance Company Law of 1921, is amended by adding a
3 section to read:
4 Section 635.2. Coverage for Colorectal Cancer Screening.--
5 (a) Except to the extent already covered under another policy,
6 all health insurance policies as defined in this section shall
7 also provide coverage for colorectal cancer screening for
8 covered individuals in accordance with the most recently
9 published American Cancer Society guidelines for colorectal
10 cancer screening and consistent with approved medical standards
11 and practices.
12 (1) Coverage for nonsymptomatic covered individuals who are
13 fifty (50) years of age or older shall include, but not be
14 limited to:
15 (i) an annual fecal occult blood test;
16 (ii) a sigmoidoscopy or a test consistent with approved
17 medical standards and practices to detect colon cancer, at least
18 once every four (4) years.
19 (iii) A colonoscopy at least once every ten (10) years.
20 (2) Coverage for symptomatic covered individuals who are
21 less than fifty (50) years of age shall include a colonoscopy,
22 sigmoidoscopy or any combination of colorectal cancer screening
23 tests at a frequency determined by a physician.
24 (b) The coverage required under this section shall be
25 subject to annual deductibles, coinsurance and copayment
26 requirements imposed by an entity subject to this section for
27 similar coverages under the same health insurance policy or
28 contract.
29 (c) For the purpose of this section:
30 (1) "Health insurance policy" means any individual or group
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1 health, sickness or accident policy or subscriber contract or
2 certificate issued by an entity subject to any one of the
3 following:
4 (i) The act of May 17, 1921 (P.L.682, No.284), known as "The
5 Insurance Company Law of 1921."
6 (ii) The act of December 29, 1972 (P.L.1701, No.364), known
7 as the "Health Maintenance Organization Act."
8 (iii) The act of May 18, 1976 (P.L.123, No.54), known as the
9 "Individual Accident and Sickness Insurance Minimum Standards
10 Act."
11 (iv) The act of December 14, 1992 (P.L.835, No.134), known
12 as the "Fraternal Benefit Societies Code."
13 (v) 40 Pa.C.S. Ch. 61 (relating to hospital plan
14 corporations) or 63 (relating to professional health services
15 plan corporations).
16 (vi) Medical assistance.
17 The term does not include accident only, fixed indemnity,
18 limited benefit, credit, dental, vision, specified disease,
19 Medicare supplement, Civilian Health and Medical Program of the
20 Uniformed Services (CHAMPUS) supplement, long-term care or
21 disability income, workers' compensation or automobile medical
22 payment insurance.
23 (2) "Colonoscopy" means an examination of the rectum and the
24 entire colon using a lighted instrument called a colonoscope.
25 (3) "Colorectal cancer screening" means any of the following
26 procedures that are furnished to an individual for the purpose
27 of early detection of colorectal cancer:
28 (i) Screening fecal-occult blood test.
29 (ii) Screening flexible sigmoidoscopy.
30 (iii) Screening colonoscopy.
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1 (iv) Screening barium enema.
2 (4) "Symptomatic person" means one of the following:
3 (i) an individual who experiences a change in bowel habits,
4 rectal bleeding or persistent stomach cramps, weight loss,
5 abdominal pain; or
6 (ii) an individual who poses a higher than average risk for
7 colorectal cancer because he or she has had colorectal cancer or
8 polyps, inflammatory bowel disease or an immediate family
9 history of such conditions.
10 Section 2. This act shall take effect in 60 days.
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