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HB2964 - 572R - I Ver
REFERENCE TITLE:
cancer screening; coverage; gene mutation
State of Arizona
House of Representatives
Fifty-seventh Legislature
Second Regular Session
2026
HB 2964
Introduced by
Representatives
Villegas: Austin, Blattman, Cavero, Connolly, Contreras L, Contreras P,
Crews, De Los Santos, Garcia, Gutierrez, Liguori, Luna-N�jera, M�rquez,
Peshlakai, Sandoval, Simacek, Stahl Hamilton
AN
ACT
amending
title 20, chapter 4, article 3, Arizona Revised Statutes, by adding section 20-841.14;
amending title 20, chapter 4, article 9, Arizona Revised Statutes, by adding
section 20-1057.21; amending title 20, chapter 6, article 4, Arizona
Revised Statutes, by adding section 20-1376.11; amending title 20,
chapter 6, article 5, Arizona Revised Statutes, by adding section 20-1406.11;
amending title 32, chapter 32, article 1, Arizona Revised Statutes, by adding
section 32-3230.03; amending title 36, chapter 29, article 1, Arizona
Revised Statutes, by adding section 36-2907.17; relating to health care
coverage.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 4, article 3,
Arizona Revised Statutes, is amended by adding section 20-841.14, to read:
START_STATUTE
20-841.14.
Genetic testing; genetic counseling; cancer; coverage;
definitions
A. A hospital service corporation or
medical service corporation that issues, delivers or renews a subscription
contract in this state on or after January 1, 2027 shall provide coverage for
subscribers as follows:
1. Under circumstances where
increased screening, risk assessment, genetic counseling or testing is
necessary based on national comprehensive cancer network guidelines.
2. For genetic counseling, genetic
testing, single-gene germline mutation testing or multigene Germline
mutation testing based on national comprehensive cancer network guidelines, if
the subscriber has a personal history or family history of cancer or inherited
gene mutation.
3. for Any genetic test for cancer
risk if the recommendation is consistent with the most recent version of the
genetic testing guidelines as published by a National Comprehensive Cancer
Network and ordered by a health care provider.
B. A hospital service corporation or
medical service corporation shall ensure that the benefits required by this
section are made available to a subscriber through a health care provider who
is a member of the provider network of the hospital service corporation or
medical service corporation.
C. Coverage under this section is not
subject to a deductible, coinsurance or any other cost sharing requirement.
D. For the purposes of this section:
1. "BRCA genes" means BRCA1
or BRCA2 genes that, when mutated, cause an increased risk of breast, ovarian,
prostate, pancreatic and melanoma cancers.
2. "Genetic test for cancer
risk" means a blood, saliva or tissue type test that reliably determines
the presence or absence of an inherited genetic characteristic that is
generally accepted in the medical or scientific community as being associated
with a statistically significant increased risk of cancer development.
3. "Germline mutation
testing" means testing for inherited genetic mutations that are associated
with an increased cancer risk based on evidence-based, clinical practice
guidelines that address genetic counseling and testing, screening and
management of individuals who have an inherited genetic mutation associated
with an increased cancer risk and that include:
(
a
) A Breast
Cancer Gene, including either of the following:
(
i
) BRCA1.
(
ii
) BRCA2.
(
b
) A Lynch
Syndrome gene, including any of the following:
(
i
) MLH1.
(
ii
) MSH2.
(
iii
) MSH6.
(
iv
) PMS2.
(
v
) EPCAM.
(
c
) Any other
hereditary cancer syndrome-related gene.
4. "Health care provider"
means a person who is licensed or certified pursuant to title 32, chapter 13,
15, 17, 25 or 29.
END_STATUTE
Sec. 2. Title 20, chapter 4, article 9, Arizona
Revised Statutes, is amended by adding section 20-1057.21, to read:
START_STATUTE
20-1057.21.
Genetic testing; genetic counseling; cancer; coverage;
definitions
A. A health care services
organization that issues, delivers or renews an evidence of coverage in this
state on or after January 1, 2027 shall provide coverage for enrollees as
follows:
1. Under circumstances where
increased screening, genetic counseling or testing is necessary based on
national comprehensive cancer network guidelines.
2. For genetic counseling, genetic
testing, single-gene germline mutation testing or multigene Germline
mutation testing based on national comprehensive cancer network guidelines, if
the enrollee has a personal history or family history of cancer or gene
mutation.
3. For Any
genetic test for cancer risk if the recommendation is consistent with the most
recent version of the genetic testing guidelines as published by a National
Comprehensive Cancer Network and ordered by a health care provider.
B. A health care services
organization shall ensure that the benefits required by this section are made
available to an enrollee through a health care provider who is a member of the
provider network of the health care services corporation.
C. Coverage
under this section is not subject to a deductible, coinsurance or any other
cost sharing requirement.
D. For the purposes of this section:
1. "BRCA genes" means BRCA1
or BRCA2 genes that, when mutated, cause an increased risk of breast, ovarian,
prostate, pancreatic and melanoma cancers.
2. "Genetic
test for cancer risk" means a blood, saliva or tissue type test that
reliably determines the presence or absence of an inherited genetic
characteristic that is generally accepted in the medical or scientific
community as being associated with a statistically significant increased risk
of cancer development.
3. "Germline mutation
testing" means testing for inherited genetic mutations that are associated
with an increased cancer risk based on evidence-based, clinical practice
guidelines that address genetic counseling and testing, screening and
management of individuals who have an inherited genetic mutation associated
with an increased cancer risk and that include:
(
a
) A Breast
Cancer Gene, including either of the following:
(
i
) BRCA1.
(
ii
) BRCA2.
(
b
) A Lynch
Syndrome gene, including any of the following:
(
i
) MLH1.
(
ii
) MSH2.
(
iii
) MSH6.
(
iv
) PMS2.
(
v
) EPCAM.
(
c
) Any other
hereditary cancer syndrome-related gene.
4. "Health care provider"
means a person who is licensed or certified pursuant to title 32, chapter 13,
15, 17, 25 or 29.
END_STATUTE
Sec. 3. Title 20, chapter 6, article 4, Arizona
Revised Statutes, is amended by adding section 20-1376.11, to read:
START_STATUTE
20-1376.11.
Genetic testing; genetic counseling; cancer; coverage;
definitions
A. A disability insurer that issues,
delivers or renews a disability insurance policy in this state on or after
January 1, 2027 shall provide coverage for insureds as follows:
1. Under circumstances where
increased screening, genetic counseling or testing is necessary based on
national comprehensive cancer network guidelines.
2. For genetic counseling, genetic
testing, single-gene germline mutation testing or multigene Germline
mutation testing based on national comprehensive cancer network guidelines, if
the insured has a personal history or family history of cancer or gene
mutation.
3. For Any genetic test for cancer
risk if the recommendation is consistent with the most recent version of the
genetic testing guidelines as published by a National Comprehensive Cancer
Network and ordered by a health care provider.
B. A disability insurer shall ensure
that the benefits required by this section are made available to an insured
through a health care provider who is a member of the provider network of the
disability insurer.
C. Coverage under this section is not
subject to a deductible, coinsurance or any other cost sharing requirement.
D. For
the purposes of this section:
1. "BRCA
genes" means BRCA1 or BRCA2 genes that, when mutated, cause an increased
risk of breast, ovarian, prostate, pancreatic and melanoma cancers.
2. "genetic test for cancer
risk" means a blood, saliva or tissue type test that reliably determines
the presence or absence of an inherited genetic characteristic that is
generally accepted in the medical or scientific community as being associated
with a statistically significant increased risk of cancer development.
3. "Germline mutation
testing" means testing for inherited genetic mutations that are associated
with an increased cancer risk based on evidence-based, clinical practice
guidelines that address genetic counseling and testing, screening and
management of individuals who have an inherited genetic mutation associated
with an increased cancer risk and that include:
(
a
) A Breast
Cancer Gene, including either of the following:
(
i
) BRCA1.
(
ii
) BRCA2.
(
b
) A Lynch
Syndrome gene, including any of the following:
(
i
) MLH1.
(
ii
) MSH2.
(
iii
) MSH6.
(
iv
) PMS2.
(
v
) EPCAM.
(
c
) Any other
hereditary cancer syndrome-related gene.
4. "Health care provider"
means a person who is licensed or certified pursuant to title 32, chapter 13,
15, 17, 25 or 29.
END_STATUTE
Sec. 4. Title 20, chapter 6, article 5, Arizona
Revised Statutes, is amended by adding section 20-1406.11, to read:
START_STATUTE
20-1406.11.
Genetic testing; genetic counseling; cancer; coverage;
definitions
A. A group disability insurer or
blanket disability insurer that issues, delivers or renews a group disability
contract or blanket disability contract in this state on or after January 1,
2027 shall provide coverage for insureds as follows:
1. Under circumstances where
increased screening, genetic counseling or testing is necessary based on
national comprehensive cancer network guidelines.
2. For genetic counseling, genetic
testing, single-gene germline mutation testing or multigene Germline
mutation testing based on national comprehensive cancer network guidelines, if
the insured has a personal history or family history of cancer or gene
mutation.
3. For any genetic test for cancer
risk if the recommendation is consistent with the most recent version of the
genetic testing guidelines as published by a National Comprehensive Cancer
Network and ordered by a health care provider.
B. A group disability insurer or
blanket disability insurer shall ensure that the benefits required by this
section are made available to an insured through a health care provider who is
a member of the provider network of the group disability insurer or blanket
disability insurer.
C. Coverage under this section is not
subject to a deductible, coinsurance or any other cost sharing requirement.
d. for the purposes of this section:
1.
"BRCA
genes
" means BRCA1 or BRCA2 genes that, when
mutated, cause an increased risk of breast, ovarian, prostate, pancreatic and
melanoma cancerS.
2. "genetic test for cancer
risk" means a blood, saliva or tissue type test that reliably determines
the presence or absence of an inherited genetic characteristic that is
generally accepted in the medical or scientific community as being associated
with a statistically significant increased risk of cancer development.
3. "Germline mutation
testing" means testing for inherited genetic mutations that are associated
with an increased cancer risk based on evidence-based, clinical practice
guidelines that address genetic counseling and testing, screening and
management of individuals who have an inherited genetic mutation associated
with an increased cancer risk and that include:
(
a
) A Breast
Cancer Gene, including either of the following:
(
i
) BRCA1.
(
ii
) BRCA2.
(
b
) A Lynch
Syndrome gene, including any of the following:
(
i
) MLH1.
(
ii
) MSH2.
(
iii
) MSH6.
(
iv
) PMS2.
(
v
) EPCAM.
(
c
) Any other
hereditary cancer syndrome-related gene.
4. "Health care provider"
means a person who is licensed or certified pursuant to title 32, chapter 13,
15, 17, 25 or 29.
END_STATUTE
Sec. 5. Title 32, chapter 32, article 1,
Arizona Revised Statutes, is amended by adding section 32-3230.03, to read:
START_STATUTE
32-3230.03.
Primary care providers; genetic testing; genetic counseling;
cancer; definitions
A. A primary care provider shall
attempt to determine whether each adult patient to whom the primary care
provider provides care has either:
1. a personal or family history of
melanoma, breast, ovarian, tubal, peritoneal, endometrial, colorectal, gastric,
pancreatic or prostate cancer.
2. an ancestry associated with a
harmful mutation in the BRCA genes or lynch syndrome genes or meets any other
criteria for hereditary cancer genetic testing as outlined in guidelines
prescribed by the national comprehensive cancer network or a similar medical
professional organization.
B. if
the primary care provider determines that an adult patient to whom the primary
care provider provides care meets the criteria prescribed in subsection A,
paragraph 1 of this section, the patient shall be provided or referred for
genetic counseling or germline mutation testing, or both, as applicable, based
on nationally recognized clinical standards.
C. If the primary care provider
determines that an adult patient to whom the primary care provider provides
care meets the criteria prescribed in subsection A, paragraph 1 of this section
and the patient has not previously tested positive for a mutation in the BRCA
genes or other genes associated with an increased cancer risk, the primary care
provider shall use an appropriate familial risk assessment tool to screen for
the risk of such a mutation. If this screening indicates that the
patient is at risk of a harmful mutation in the BRCA genes or other genes
associated with an increased cancer risk, the primary care provider shall do
both of the following:
1. Provide genetic counseling to the
patient or refer the patient for genetic counseling.
2. If a genetic test for harmful
mutations in the BRCA genes or other genes associated with an increased cancer
risk is clinically indicated as a result of the genetic counseling, administer
a genetic test for cancer risk to the patient or refer the patient for genetic
testing.
D. for the purposes of this section:
1.
"BRCA
genes
" means BRCA1 or BRCA2 genes that, when
mutated, cause an increased risk of breast, ovarian, prostate, pancreatic and
melanoma cancerS.
2. "genetic test for cancer
risk" means a blood, saliva or tissue type test that reliably determines
the presence or absence of an inherited genetic characteristic that is
generally accepted in the medical or scientific community as being associated
with a statistically significant increased risk of cancer development.
3. "Germline mutation
testing" means testing for inherited genetic mutations that are associated
with an increased cancer risk based on evidence-based, clinical practice
guidelines that address genetic counseling and testing, screening and
management of individuals who have an inherited genetic mutation associated
with an increased cancer risk and that include:
(
a
) A Breast
Cancer Gene, including either of the following:
(
i
) BRCA1.
(
ii
) BRCA2.
(
b
) A Lynch
Syndrome gene, including any of the following:
(
i
) MLH1.
(
ii
) MSH2.
(
iii
) MSH6.
(
iv
) PMS2.
(
v
) EPCAM.
(
c
) Any other
hereditary cancer syndrome-related gene.
4. "Health care provider"
means a person who is licensed or certified pursuant to chapter 13, 15, 17, 25
or 29 of this title.
END_STATUTE
Sec. 6. Title 36, chapter 29, article 1,
Arizona Revised Statutes, is amended by adding section 36-2907.17, to read:
START_STATUTE
36-2907.17.
Genetic testing; genetic counseling; cancer
The administration and its contractors, to the
extent authorized by federal law, shall provide screening, genetic counseling,
genetic testing and germline mutation testing for harmful inherited genetic
mutations in the BRCA genes or other genes that cause an increased cancer risk
for members when indicated pursuant to section 32-3230.03.
END_STATUTE
Sec. 7.
Short title
This act may be cited as the
"Donna Hicks and Clarissa Amparano Act".