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H.B. 366

             1     

HEALTH INSURANCE - SCREENING

             2     
COVERAGE

             3     
2007 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Chief Sponsor: Christine A. Johnson

             6     
Senate Sponsor: ____________

             7     
             8      LONG TITLE
             9      General Description:
             10          This bill requires health insurers to offer coverage for the screening of several types of
             11      cancer and other conditions.
             12      Highlighted Provisions:
             13          This bill:
             14          .    requires health insurers to offer coverage for the screening of several types of cancer
             15      and other conditions;
             16          .    specifies that insurers are not required to cover diagnostic tests as part of the offer
             17      of coverage;
             18          .    prohibits insurers from imposing cost sharing provisions for the offered screenings
             19      greater than those required for other screenings or medical conditions;
             20          .    requires an insurer to notify members of a group that a policy does not include
             21      coverage for the offered screenings if the offer of coverage was declined; and
             22          .    grants rulemaking authority.
             23      Monies Appropriated in this Bill:
             24          None
             25      Other Special Clauses:
             26          None
             27      Utah Code Sections Affected:


             28      ENACTS:
             29          31A-22-635, Utah Code Annotated 1953
             30     
             31      Be it enacted by the Legislature of the state of Utah:
             32          Section 1. Section 31A-22-635 is enacted to read:
             33          31A-22-635. Coverage for cancer and HPV screenings.
             34          (1) To each group or individual seeking to renew or purchase a health insurance policy
             35      or a health maintenance organization contract, an insurer shall offer a policy or contract that
             36      includes coverage for screening for the following conditions:
             37          (a) colon cancer;
             38          (b) prostate cancer;
             39          (c) human papillomavirus (HPV); and
             40          (d) cervical neoplasia and cancer, using the Papanicolaou (Pap) test.
             41          (2) Coverage under Subsection (1):
             42          (a) includes interpretation of the screening results;
             43          (b) does not include diagnostic tests performed on a person suspected of having any of
             44      the conditions under Subsection (1); and
             45          (c) may not include copays, deductibles, coinsurance, or other provisions that would
             46      require greater cost sharing by the insured than for the screening or diagnosis of other medical
             47      conditions.
             48          (3) If an employer or other group renews or purchases a health insurance policy or a
             49      health maintenance organization contract but declines the coverage offered under Subsection
             50      (1), the insurer shall notify each insured within the group that the screenings under Subsection
             51      (1) are not included in the policy or contract.
             52          (4) As necessary, the commissioner shall make rules to implement the provisions of
             53      this section.




Legislative Review Note
    as of 1-26-07 11:26 AM


Office of Legislative Research and General Counsel


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