OLR Bill Analysis

SB 12 (File 6, as amended by Senate “A”)*

AN ACT CONCERNING HEALTH INSURANCE COVERAGE FOR BREAST MAGNETIC RESONANCE IMAGING.

SUMMARY:

This bill changes the entity whose recommendation health insurers must follow in determining the level of coverage to provide for colorectal cancer screening. By law, specified health insurance policies must cover colorectal cancer screening, including 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 them to cover the tests in accordance with the American Cancer Society's recommendations.

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

*Senate Amendment “A” replaces the underlying bill, which removed a requirement that insurance policies cover magnetic resonance imaging in accordance with guidelines established by the American Cancer Society or the American College of Radiology.

EFFECTIVE DATE: January 1, 2013

COMMITTEE ACTION

Insurance and Real Estate Committee

Joint Favorable

Yea

12

Nay

7

(02/21/2012)