AB 217

This bill requires health insurance policies and plans that cover any diagnostic

or surgical procedures to cover colorectal cancer examinations and laboratory tests

for any insured or enrollee who is 50 years of age or older or any insured or enrollee

who is under 50 years of age and at high risk for colorectal cancer. The bill requires

the commissioner of insurance, in consultation with the secretary of health services,

to promulgate rules that specify guidelines for the colorectal cancer screening that

must be covered, and that specify factors for determining whether an individual is

at high risk for colorectal cancer, in accordance with the guidelines of the American

Cancer Society for colorectal cancer screening.

The coverage requirement applies to both individual and group health

insurance policies and plans, including defined network plans and cooperative

sickness care associations; to health care plans offered by the state to its employees,

including a self-insured plan; and to self-insured health plans of counties, cities,

towns, villages, and school districts. The requirement specifically does not apply to

limited-scope benefit plans or to policies covering only certain specified diseases

other than cancer. The required coverage may be subject to any limitations,

exclusions, or cost-sharing provisions that apply generally under the policy or plan.