Bill > HB1123

This bill amends existing Pennsylvania law, specifically "The Insurance Company Law of 1921," to expand coverage for colorectal cancer screening tests under health insurance policies. It lowers the age for recommended screenings for individuals without symptoms from 50 to 45 years old and broadens the types of approved screening tests, including annual fecal occult blood or fecal immunochemical tests, sigmoidoscopy, computed tomography (CT) colonography, colonoscopy, multi-target stool DNA tests, multi-target stool RNA tests, and cell-free DNA or other blood-based screening tests, all to be performed at frequencies aligned with approved medical guidelines. The bill also clarifies that coverage for these screenings, including follow-up colonoscopies after positive non-invasive tests, should not be subject to cost-sharing like deductibles, coinsurance, or copayments, though insurers can still apply utilization review and cost-sharing for screenings beyond the minimum required coverage. The definition of "health insurance policy" is updated to be more inclusive of various coverage types while excluding specific limited benefit plans, and "approved medical guidelines" are now defined to include those from the American Cancer Society, National Comprehensive Cancer Network, and Centers for Medicare and Medicaid Services. The bill specifies when these new coverage requirements will take effect for different types of health insurance policies.