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Bill > SF417

IA SF417

A bill for an act relating to insurance coverage and Medicaid coverage for annual lung cancer screenings for at-risk individuals.

summary

Introduced
02/24/2025
In Committee
02/24/2025
Crossed Over
Passed
Dead

Introduced Session

91st General Assembly

Bill Summary

This bill relates to insurance coverage and medical assistance program (Medicaid) coverage for annual lung cancer screenings for at-risk individuals. The bill defines “at-risk individual” as a recipient or covered person 50 years of age or older that either has smoked cigarettes regularly or experienced secondhand smoke regularly, has an immediate family member diagnosed with lung cancer, or has been regularly exposed to asbestos, radon, arsenic, nickel, chromium, tar, or soot in the individual’s home or workplace. The bill defines “lung cancer screening” as a scan of the lungs using low-dose computed tomography. Under the bill, the department of health and human services shall seek any federal waiver necessary for Medicaid to provide coverage for an annual lung cancer screening for at-risk individuals. Contingent on receiving approval of, and effective immediately upon receiving approval of, a federal waiver, Medicaid shall provide coverage for annual lung cancer screenings for at-risk individuals. The bill requires a policy, contract, or plan providing for third-party payment or prepayment of health or medical expenses to provide coverage for an annual lung cancer screening for an at-risk individual. Cost-sharing shall not be imposed by a health carrier for coverage required under the bill. Coverage required under the bill shall not be less favorable than coverage a health carrier offers for screening mammograms. The bill applies to third-party payment providers enumerated in the bill, and the commissioner of insurance may adopt rules to administer the requirements of the bill applying to such third-party payment providers. The bill specifies the types of specialized health-related insurance which are not subject to the coverage requirements of the bill.

AI Summary

This bill aims to expand insurance and Medicaid coverage for annual lung cancer screenings for individuals at high risk of developing lung cancer. The bill defines an "at-risk individual" as someone 50 years or older who has either regularly smoked or been exposed to secondhand smoke, has an immediate family member with lung cancer, or has been regularly exposed to hazardous substances like asbestos or radon in their home or workplace. The lung cancer screening is specifically defined as a low-dose computed tomography scan. The bill requires the state's Department of Health and Human Services to seek a federal waiver to provide Medicaid coverage for these annual screenings, and once approved, Medicaid will be required to cover the screenings for eligible individuals. Additionally, the bill mandates that all health insurance policies and plans must provide coverage for these screenings without imposing any cost-sharing (such as copayments, deductibles, or other out-of-pocket expenses) and ensures that the coverage is at least as comprehensive as mammogram screenings. The bill applies to various types of health insurance plans, including individual and group accident and sickness insurance, hospital and medical service contracts, and health maintenance organization contracts, but specifically excludes certain specialized insurance types like dental, vision, and workers' compensation insurance.

Committee Categories

Business and Industry

Sponsors (11)

Last Action

Subcommittee: Driscoll, Bisignano, and Klimesh. S.J. 357. (on 02/25/2025)

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