OLR Bill Analysis

SB 98

AN ACT CONCERNING DEDUCTIBLES AND GUIDELINES FOR COLONOSCOPIES.

SUMMARY:

This bill bars insurers from charging a deductible for procedures a physician initially undertakes as a colorectal cancer screening colonoscopy or sigmoidoscopy. (A colonoscopy covers the entire lower intestine; a sigmoidoscopy extends only to the lower colon. ) Some insurers currently charge a deductible when these screening procedures discover a polyp, which is removed at the same time.

By law, specified individual and group insurance policies must cover colonoscopies, sigmoidoscopies, and radiological imaging. Under current law, they must do so following recommendations established by the American College of Gastroenterology, after its consultation with the American Cancer Society and the American College of Radiology. The bill instead requires insurers to cover the tests in accordance with the recommendations of any one of these groups.

The affected individual and group health insurance policies are those issued, amended, renewed, or continued that cover (1) basic hospital expenses; (2) basic medical-surgical expenses; (3) major medical expenses; and (4) hospital or medical services, including coverage under an HMO plan. Due to the federal Employee Retirement and Income Security Act (ERISA), state health insurance mandates do not apply to self-insured benefit plans.

EFFECTIVE DATE: January 1, 2013

Insurance and Real Estate Committee

Joint Favorable

Yea

15

Nay

5

(02/28/2012)