Creates provisions relating to insurance coverage of genetic screenings for cancer risk

SECOND REGULAR SESSION
HOUSE BILL NO. 1879
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE REUTER.
4682H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o amend chapter 376, RSMo, by adding thereto one new section relating to insurance
coverage of genetic screenings for cancer risk.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto one new section, to be
2 known as section 376.1260, to read as follows:
376.1260. 1. As used in this section, the following terms mean:
2 (1) "Cost-sharing r equir ement", any deductible, coinsurance, co-payment, or
3 maximum limitation on the application of such deductible, coinsurance, co-payment, or
4 similar out-of-pocket expense;
5 (2) "Genetic counseling", the pr ovision of services to individuals, couples,
6 families, and organizations by one or mor e appr opriately trained individuals to addr ess
7 the physical and psychological issues associated with the occurr ence or risk of
8 occurr ence of a genetic disorder , birth defect, or genetically influenced condition or
9 disease in an individual or a family;
10 (3) "Health benefit plan", the same meaning as is ascribed to such term in
11 section 376.1350;
12 (4) "Health carrier", the same meaning as is ascribed to such term in section
13 376.1350.
14 2. Each health benefit plan deliver ed, issued for delivery , continued, or rene wed
15 on or after January 1, 2027, shall pr ovide coverage for genetic counseling and genetic
16 testing provi ded by an individual certified by an accr editing body , recogn ized by the
17 department of commer ce and insurance, to prov ide genetic counseling and genetic
EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.
18 testing. The coverage r equir ed under this section shall include all costs associated with
19 genetic counseling and, if indicated after genetic counseling, a genetic laboratory test of
20 genes for individuals assessed to be at an increa sed risk, based on a clinical risk
21 assessment tool, of potentially harmful mutations in genes due to a personal or family
22 history of cancer .
23 3. No health benefit plan or health carrier shall consider , or req uest appr oval to
24 consider , the res ults of any genetic testing or the pr ovision of genetic counseling
25 pr ovided in accordance with this section in determining eligibility for coverage,
26 establishing pr emiums, limiting coverage, re newing coverage, or any other underwriting
27 decision. A violation of this subsection shall constitute a violation of section 375.1303.
28 4. No health benefit plan shall impose any cost-sharing req uirement with res pect
29 to coverage requ ired under this section. If application of this section would res ult in
30 health savings account ineligibility under Section 223 of the Internal Revenue Code of
31 1986, as amended, this section shall apply to health savings account-qualified high
32 deductible health plans with res pect to any cost-sharing under the plans only after an
33 enr ollee has satisfied the minimum deductible under Section 223, except with res pect to
34 items or services that ar e prev entive care under Section 223(c)(2)(C) of the Internal
35 Revenue Code of 1986, as amended, in which case the requ irem ents of this section shall
36 apply reg ardless of whether the minimum deductible under Section 223 has been
37 satisfied.
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HB 1879 2