Bill Text: NJ S3282 | 2020-2021 | Regular Session | Introduced
Bill Title: Reduces age at which health benefit plans cover colorectal cancer screenings from 50 to 45.
Spectrum: Slight Partisan Bill (Democrat 8-3)
Status: (Introduced - Dead) 2021-02-11 - Referred to Senate Budget and Appropriations Committee [S3282 Detail]
Download: New_Jersey-2020-S3282-Introduced.html
Sponsored by:
Senator VIN GOPAL
District 11 (Monmouth)
SYNOPSIS
Reduces age at which health benefit plans cover colorectal cancer screenings from 50 to 45.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning health benefits for colorectal cancer screenings, amending P.L.2001, c.295, and supplementing P.L.1961, c.49.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. Section 1 of P.L.2001, c.295 (C.17:48-6y) is amended to read as follows:
1. Every hospital service corporation contract that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1938, c.366 (C.17:48-1 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act, shall provide benefits to any named subscriber or other person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age [50] 45 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person.
As used in this section, "high risk for colorectal cancer" means a person has:
a. a family history of: familial adenomatous polyposis; hereditary non-polyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps;
b. chronic inflammatory bowel disease; or
c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
The provisions of this section shall apply to all hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.
(cf: P.L.2001, c.295, s.1)
2. Section 2 of P.L.2001, c.295 (C.17:48A-7x) is amended to read as follows:
2. Every medical service corporation contract that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1940, c.74 (C.17:48A-1 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act, shall provide benefits to any named subscriber or other person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age [50] 45 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person.
As used in this section, "high risk for colorectal cancer" means a person has:
a. a family history of: familial adenomatous polyposis; hereditary non-polyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps;
b. chronic inflammatory bowel disease; or
c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
The provisions of this section shall apply to all medical service corporation contracts in which the medical service corporation has reserved the right to change the premium.
(cf: P.L.2001, c.295, s.2)
3. Section 3 of P.L.2001, c.295 (C.17:48E-35.23) is amended to read as follows:
3. Every health service corporation contract that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1985, c.236 (C.17:48E-1 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act, shall provide benefits to any named subscriber or other person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age [50] 45 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person.
As used in this section, "high risk for colorectal cancer" means a person has:
a. a family history of: familial adenomatous polyposis; hereditary non-polyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps;
b. chronic inflammatory bowel disease; or
c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer.
The benefits shall be provided to the same extent as for any other medical condition under the contract.
The provisions of this section shall apply to all health service corporation contracts in which the health service corporation has reserved the right to change the premium.
(cf: P.L.2001, c.295, s.3)
4. Section 4 of P.L.2001, c.295 (C.17B:26-2.1u) is amended to read as follows:
4. Every individual policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:23-1 et seq., or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act, shall provide benefits to any named insured or other person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age [50] 45 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person.
As used in this section, "high risk for colorectal cancer" means a person has:
a. a family history of: familial adenomatous polyposis; hereditary nonpolyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps;
b. chronic inflammatory bowel disease; or
c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer.
The benefits shall be provided to the same extent as for any other medical condition under the policy.
The provisions of this section shall apply to all health insurance policies in which the insurer has reserved the right to change the premium.
(cf: P.L.2001, c.295, s.4)
5. Section 5 of P.L.2001, c.295 (C.17B:27-46.1y) is amended to read as follows:
5. Every group policy that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to N.J.S.17B:27-26 et seq., or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act, shall provide benefits to any named insured or other person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age [50] 45 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person.
As used in this section, "high risk for colorectal cancer" means a person has:
a. a family history of: familial adenomatous polyposis; hereditary nonpolyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps;
b. chronic inflammatory bowel disease; or
c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer.
The benefits shall be provided to the same extent as for any other medical condition under the policy.
The provisions of this section shall apply to all health insurance policies in which the insurer has reserved the right to change the premium.
(cf: P.L.2001, c.295, s.5)
6. Section 8 of P.L.2001, c.295 (C.26:2J-4.24) is amended to read as follows:
8. Every enrollee agreement that provides hospital or medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.), or approved for issuance or renewal in this State by the Commissioner of Banking and Insurance on or after the effective date of this act, shall provide health care services to any enrollee or other person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age [50] 45 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person.
As used in this section, "high risk for colorectal cancer" means a person has:
a. a family history of: familial adenomatous polyposis; hereditary non-polyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps;
b. chronic inflammatory bowel disease; or
c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer.
The health care services shall be provided to the same extent as for any other medical condition under the enrollee agreement.
The provisions of this section shall apply to all enrollee agreements in which the health maintenance organization has reserved the right to change the schedule of charges.
(cf: P.L.2012, c.17, s.273)
7. Section 6 of P.L.2001, c.295 (C.17B:27A-7.7) is amended to read as follows:
6. Every individual health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), or approved for issuance or renewal in this State on or after the effective date of this act, shall provide benefits to any person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age [50] 45 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person.
As used in this section, "high risk for colorectal cancer" means a person has:
a. a family history of: familial adenomatous polyposis; hereditary non-polyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps;
b. chronic inflammatory bowel disease; or
c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer.
The benefits shall be provided to the same extent as for any other medical condition under the health benefits plan.
The provisions of this section shall apply to all health benefit plans in which the carrier has reserved the right to change the premium.
(cf: P.L.2001, c.295, s.6)
8. Section 7 of P.L.2001, c.295 (C.17B:27A-19.9) is amended to read as follows:
7. Every small employer health benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.), or approved for issuance or renewal in this State on or after the effective date of this act, shall provide benefits to any person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age [50] 45 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person.
As used in this section, "high risk for colorectal cancer" means a person has:
a. a family history of: familial adenomatous polyposis; hereditary non-polyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps;
b. chronic inflammatory bowel disease; or
c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer.
The benefits shall be provided to the same extent as for any other medical condition under the health benefits plan.
The provisions of this section shall apply to all health benefit plans in which the carrier has reserved the right to change the premium.
(cf: P.L.2001, c.295, s.7)
9. (New Section) Every State Health Benefits plan that provides hospital or medical expense benefits and is delivered, issued, executed or renewed in this State pursuant to P.L.1961, c.49 (C.52:14-17.25 et seq.), or approved for issuance or renewal in this State on or after the effective date of this act, shall provide benefits to any person covered thereunder for expenses incurred in conducting colorectal cancer screening at regular intervals for persons age 45 and over and for persons of any age who are considered to be at high risk for colorectal cancer. The methods of screening for which benefits shall be provided shall include: a screening fecal occult blood test, flexible sigmoidoscopy, colonoscopy, barium enema, or any combination thereof; or the most reliable, medically recognized screening test available. The method and frequency of screening to be utilized shall be in accordance with the most recent published guidelines of the American Cancer Society and as determined medically necessary by the covered person's physician, in consultation with the covered person.
As used in this section, "high risk for colorectal cancer" means a person has:
a. a family history of: familial adenomatous polyposis; hereditary non-polyposis colon cancer; or breast, ovarian, endometrial or colon cancer or polyps;
b. chronic inflammatory bowel disease; or
c. a background, ethnicity or lifestyle that the physician believes puts the person at elevated risk for colorectal cancer.
The benefits shall be provided to the same extent as for any other medical condition under the State Health Benefits plan.
10. This act shall take effect immediately.
STATEMENT
This bill reduces the age in which health benefit plans are required to cover regular colorectal cancer screenings from 50 to 45.
Presently, health benefit plans are only required to cover a colorectal cancer screening at regular intervals for a person who is aged 50 and over, or for a person of any age who is considered to be at high risk for colorectal cancer.
Under this bill, the age in which a regular colorectal cancer screening will be covered by health benefit plans is lowered from age 50 to age 45. Additionally, State Health Benefit Plans will now cover colorectal cancer screenings.
