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AN ACT relating to coverage for colorectal cancer examinations and laboratory 1
tests and declaring an emergency. 2
Be it enacted by the General Assembly of the Commonwealth of Kentucky: 3
Section 1. KRS 304.17A-257 is amended to read as follows: 4
(1) A health benefit plan shall provide coverage for all colorectal cancer examinations 5
and laboratory tests specified in the most recent version of a Centers for Medicare 6
and Medicaid Services national coverage determination or nationally recognized 7
clinical practice guidelines, including guidelines published by the American 8
Cancer Society and the National Comprehensive Cancer Network and 9
recommendations of the United States Preventive Services Task Force, [ 10
guidelines] for individuals referenced in paragraph ( b)1. of this subsection and the 11
most recent version of the United States Multi -Society Task Force on Colorectal 12
Cancer guidelines for individuals referenced in paragraph (b)2. of this subsection 13
for complete colorectal cancer screening of asymptomatic individuals as follows: 14
(a) Coverage or benefits shall: 15
1. Include coverage for all United States Food and Drug Administration -16
approved bowel preparation prescribed in connection with a colorectal 17
cancer examination or laboratory test; and 18
2. Be provided for all colorectal cancer examinations and laboratory tests 19
administered at a frequency identified in the relevant guidelines; and 20
(b) The covered individual shall be: 21
1. Forty-five (45) years of age or older; or 22
2. Less than forty -five (45) ye ars of age and at high risk for colorectal 23
cancer. 24
(2) (a) Except as provided in paragraph (b) of this subsection, the coverage required 25
by this section shall not be subject to: 26
1. Prior authorization; or 27
UNOFFICIAL COPY 26 RS BR 2059
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2. A deductible, coinsurance, or any other cost -sharing requirements for 1
services received from participating providers under the health benefit 2
plan. 3
(b) If the application of any requirement of paragraph (a)2. of this subsection 4
would be the sole cause of a health benefit plan's failure to qualify as a H ealth 5
Savings Account-qualified High Deductible Health Plan under 26 U.S.C. sec. 6
223, as amended, then the requirement shall not apply to that health benefit 7
plan until the minimum deductible under 26 U.S.C. sec. 223, as amended, is 8
satisfied. 9
(3) This section shall not be construed to limit coverage required by KRS 304.17A -259 10
or any other law. 11
Section 2. Section 1 of this Act applies to health benefit plans issued or 12
renewed on or after the effective date of this Act. 13
Section 3. If the Cabinet for Health and Family Services or the Department for 14
Medicaid Services determines that a state plan amendment, waiver, or any other form of 15
authorization or approval from any federal agency to im plement Section 1 of this Act's 16
application to KRS 205.522 is necessary to prevent the loss of federal funds or to comply 17
with federal law, the cabinet or department: 18
(1) Shall, within 90 days after the effective date of this Act, request the necessary 19
federal authorization or approval to implement Section 1 of this Act's application to KRS 20
205.522; and 21
(2) May only delay implementation of Section 1 of this Act's application to KRS 22
205.522 for which federal authorization or approval was deemed necessary unt il the 23
federal authorization or approval is granted. 24
Section 4. Sections 1 and 3 of this Act shall constitute the specific authorization 25
required under KRS 205.5372(1). 26
Section 5. Wher eas adequate coverage for colorectal cancer examinations and 27
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laboratory tests is critical for the health of the citizens of the Commonwealth, an 1
emergency is declared to exist, and this Act takes effect upon its passage and approval by 2
the Governor or upon its otherwise becoming a law. 3