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A bill for an act
relating to health insurance; requiring health plans to provide coverage for cancer
screenings pursuant to American Cancer Society guidelines; amending Minnesota
Statutes 2024, sections 62A.30, subdivision 2; 62Q.50; proposing coding for new
law in Minnesota Statutes, chapter 62Q.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
Section 1.
Minnesota Statutes 2024, section 62A.30, subdivision 2, is amended to read:
Subd. 2.
Required coverage.
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(a)
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Every policy, plan, certificate, or contract referred to
in subdivision 1 that provides coverage to a Minnesota resident must provide coverage for
routine screening procedures for cancer and the office or facility visit, including
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mammograms,
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surveillance tests for ovarian cancer for women who are at risk for ovarian
cancer as defined in subdivision 3
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, pap smears, and colorectal screening tests for men and
women, when ordered or provided by a physician in accordance with the standard practice
of medicine
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.
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(b) Coverage for colorectal cancer screening must be provided consistent with current
American Cancer Society guidelines. Routine screening procedures include all colorectal
examinations and tests that are administered at a frequency identified in current American
Cancer Society screening guidelines, including but not limited to a follow-up colonoscopy
conducted after a positive noninvasive stool-based screening test, blood test, or direct
visualization test.
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(c) Coverage must be provided for all breast cancer screening examinations and tests
that are administered at a frequency identified in current American Cancer Society guidelines
for individuals of average risk and individuals of high risk of developing breast cancer,
including all breast examinations required by subdivisions 4 and 5.
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(d) A health plan must not impose cost-sharing requirements, including co-pays,
deductibles, or coinsurance, on the coverage required under this section.
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Sec. 2.
Minnesota Statutes 2024, section 62Q.50, is amended to read:
62Q.50 PROSTATE CANCER SCREENING.
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(a)
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A health plan must cover prostate cancer screening
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for men 40 years of age or over
who are symptomatic or in a high-risk category and for all men 50 years of age or older
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consistent with current American Cancer Society screening guidelines
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.
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The screening must consist at a minimum of a prostate-specific antigen blood test and
a digital rectal examination.
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This coverage is subject to any deductible, coinsurance, co-payment, or other limitation
on coverage applicable to other coverages under the plan.
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(b) The coverage must include all prostate cancer screening examinations and tests that
are administered at a frequency identified in current American Cancer Society screening
guidelines, including follow-up examinations. Follow-up examinations include but are not
limited to urinary analysis, serum biomarker testing, medical imaging, or biopsy.
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(c) A health plan must not impose cost-sharing requirements, including co-pays,
deductibles, or coinsurance, on the coverage required under this section.
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(d)
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For purposes of this section, "health plan" includes coverage that is excluded under
section
62A.011, subdivision 3
, clauses (7) and (10).
Sec. 3.
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[62Q.501] CERVICAL CANCER SCREENING.
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(a) A health plan must cover cervical cancer screening for women consistent with current
American Cancer Society screening guidelines.
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(b) The coverage must include all cervical cancer screening examinations and tests that
are administered at a frequency identified in current American Cancer Society screening
guidelines, including follow-up examinations used to evaluate an abnormality seen or
suspected from a cervical cancer screening, regardless of whether different samples from
the prior cervical cancer screening are used or the follow-up examination is performed on
a different date than the cervical cancer screening. Follow-up examinations include but are
not limited to human papillomavirus examinations with typing, cytology, dual stain, or
colposcopy with biopsy.
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(c) A health plan must not impose cost-sharing requirements, including co-pays,
deductibles, or coinsurance, on the coverage required under this section.
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Sec. 4.
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[62Q.502] LUNG CANCER SCREENING.
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(a) A health plan must cover lung cancer screening consistent with current American
Cancer Society screening guidelines.
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(b) The coverage must include all lung cancer screening examinations and tests that are
administered at a frequency identified in current American Cancer Society screening
guidelines, including follow-up examinations. Follow-up examinations include but are not
limited to chest x-ray, computed tomography scan, magnetic resonance imaging, positron
emission tomography scan, or biopsy.
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(c) A health plan must not impose cost-sharing requirements, including co-pays,
deductibles, or coinsurance, on the coverage required under this section.
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Sec. 5.
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EFFECTIVE DATE.
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Sections 1 to 4 are effective January 1, 2027, and apply to health plans offered, issued,
or renewed on or after that date.
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