2021 -- H 5432 SUBSTITUTE A

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2021

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A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES --

     THE MARYELLEN GOODWIN COLORECTAL CANCER SCREENING ACT

     

     Introduced By: Representatives Ackerman, Chippendale, Hawkins, Baginski, and
McNamara

     Date Introduced: February 08, 2021

     Referred To: House Health & Human Services

     It is enacted by the General Assembly as follows:

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     SECTION 1. This act shall be known and may be cited as the "Maryellen Goodwin

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Colorectal Cancer Screening Act.”

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     SECTION 2. Section 27-18-58 of the General Laws in Chapter 27-18 entitled "Accident

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and Sickness Insurance Policies" is hereby amended to read as follows:

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     27-18-58. Prostate and colorectal examinations -- Coverage mandated. Prostate and

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colorectal examinations -- Coverage mandated -- The Maryellen Goodwin Colorectal Cancer

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Screening Act.

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     (a) Every individual or group hospital or accident and sickness insurance policy, medical

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expense insurance policy or individual or group hospital or medical services plan contract

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delivered, issued for delivery, or renewed in this state shall provide coverage for prostate and

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colorectal preventive screening examinations and laboratory tests for cancer for any

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nonsymptomatic person covered under that policy or contract, in accordance with the current

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American Cancer Society guidelines. The coverage required by this section shall include preventive

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colorectal cancer screening coverage for all colorectal cancer examinations and laboratory tests in

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accordance with American Cancer Society Guidelines, including for colorectal cancer screening of

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average risk individuals, including an initial colonoscopy or other medical test or procedure for

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colorectal cancer screening and a follow-up colonoscopy if the results of the initial medical test or

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procedure are abnormal. Provided, this section does not apply to insurance coverage providing

 

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benefits for: (1) hospital confinement indemnity; (2) disability income; (3) accident only; (4) long-

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term care; (5) Medicare supplement; (6) limited benefit health; (7) specific disease indemnity; (8)

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sickness or bodily injury or death by accident or both; and (9) other limited benefit policies.

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     (b) An insurer may not impose cost sharing on the coverage required by subsection (a) of

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this section when the services are delivered within the health insurer's provider network.

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     SECTION 3. Section 27-19-49 of the General Laws in Chapter 27-19 entitled "Nonprofit

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Hospital Service Corporations" is hereby amended to read as follows:

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     27-19-49. Prostate and colorectal examinations -- Coverage mandated. Prostate and

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colorectal examinations -- Coverage mandated -- The Maryellen Goodwin Colorectal Cancer

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Screening Act.

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     (a) Subscribers to any nonprofit hospital service corporation plan shall be afforded

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coverage under the plan for prostate and colorectal examinations and laboratory tests for cancer for

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any nonsymptomatic person covered under the policy or plan contract, in accordance with the

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current American Cancer Society guidelines. The coverage required by this section shall include

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preventive colorectal cancer screening coverage for all colorectal cancer examinations and

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laboratory tests in accordance with American Cancer Society Guidelines, including for colorectal

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cancer screening of average risk individuals, including an initial colonoscopy or other medical test

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or procedure for colorectal cancer screening and a follow-up colonoscopy if the results of the initial

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medical test or procedure are abnormal.

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     (b) An insurer or the corporation may not impose cost sharing on the coverage required by

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subsection (a) of this section when the services are delivered within the health insurer's provider

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network.

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     SECTION 4. Section 27-20-44 of the General Laws in Chapter 27-20 entitled "Nonprofit

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Medical Service Corporations" is hereby amended to read as follows:

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     27-20-44. Prostate and colorectal examinations -- Coverage mandated. Prostate and

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colorectal examinations -- Coverage mandated -- The Maryellen Goodwin Colorectal Cancer

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Screening Act.

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     (a) Subscribers to any nonprofit medical service corporation plan shall be afforded

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coverage under the plan for prostate and colorectal examinations and laboratory tests for cancer for

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any nonsymptomatic person covered under the policy or plan contract, in accordance with the

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current American Cancer Society guidelines. The coverage required by this section shall include

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preventive colorectal cancer screening coverage for all colorectal cancer examinations and

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laboratory tests in accordance with American Cancer Society Guidelines, including for colorectal

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cancer screening of average risk individuals, including an initial colonoscopy or other medical test

 

LC000514/SUB A - Page 2 of 3

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or procedure for colorectal cancer screening and a follow-up colonoscopy if the results of the initial

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medical test or procedure are abnormal.

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     (b) An insurer or the corporation may not impose cost sharing on the coverage required by

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subsection (a) of this section when the services are delivered within the health insurer's provider

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network.

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     SECTION 5. Section 27-41-60 of the General Laws in Chapter 27-41 entitled "Health

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Maintenance Organizations" is hereby amended to read as follows:

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     27-41-60. Prostate and colorectal examinations -- Coverage mandated. Prostate and

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colorectal examinations -- Coverage mandated -- The Maryellen Goodwin Colorectal Cancer

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Screening Act.

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     (a) Subscribers to any health maintenance organization plan shall be afforded coverage

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under that plan for prostate and colorectal examinations and laboratory tests for cancer for any

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nonsymptomatic person covered under the policy or plan. contract, in accordance with the current

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American cancer society guidelines. The coverage required by this section shall include preventive

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colorectal cancer screening coverage for all colorectal cancer examinations and laboratory tests in

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accordance with American Cancer Society Guidelines, including for colorectal cancer screening of

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average risk individuals, including an initial colonoscopy or other medical test or procedure for

18

colorectal cancer screening and a follow-up colonoscopy if the results of the initial medical test or

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procedure are abnormal.

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     (b) An insurer or the organization may not impose cost sharing on the coverage required

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by subsection (a) of this section when the services are delivered within the health insurer's provider

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network.

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     SECTION 6. This act shall take effect upon passage and shall apply to policies or plans

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delivered, issued for delivery or renewed in this state on and after January 1, 2022.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES --

     THE MARYELLEN GOODWIN COLORECTAL CANCER SCREENING ACT

***

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     This act would provide insurance coverage for certain prostate and colorectal preventive

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screening examinations and would prohibit cost sharing for persons related to colorectal screening

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examinations, laboratory tests, initial and follow-up colonoscopies covered by health insurance

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policies or plans.

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     This act would take effect upon passage and would apply to policies or plans delivered,

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issued for delivery or renewed in this state on and after January 1, 2022.

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