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SECOND REGULAR SESSION
SENATE BILL NO. 1113
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR MOSLEY .
3361S.01I KRISTINA MARTIN, Secretary
AN ACT
To 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 1
one new section, to be known as section 376.1260, to read as 2
follows:3
376.1260. 1. As used in this section, the following 1
terms mean: 2
(1) "Cost-sharing requirement", any deductible, 3
coinsurance, co-payment, or maximum limitation on the 4
application of such deductible, coinsurance, co-payment, or 5
similar out-of-pocket expense; 6
(2) "Genetic counseling", the provision of services to 7
individuals, couples, families, and organizations by one or 8
more appropriately trained individuals to address the 9
physical and psychological issues associated with the 10
occurrence or risk of occurrence of a genetic disorder, 11
birth defect, or genetically influenced condition or disease 12
in an individual or a family; 13
(3) "Health benefit plan", the same meaning as is 14
ascribed to such term in section 376.1350; 15
(4) "Health carrier", the same meaning as is ascribed 16
to such term in section 376.1350. 17
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2. Each health benefit plan delivered, issued for 18
delivery, continued or renewed on or after January 1, 2027, 19
shall provide coverage for genetic counseling and genetic 20
testing provided by an individual certified by an 21
accrediting body, recognized by the department of commerce 22
and insurance, to provide genetic counseling and genetic 23
testing. The coverage required under this section shall 24
include all costs associated with genetic counseling and, if 25
indicated after genetic counseling, a genetic laboratory 26
test of genes for individuals assessed to be at an increased 27
risk, based on a clinical risk assessment tool, of 28
potentially harmful mutations in genes due to a personal or 29
family history of cancer. 30
3. No health benefit plan or health carrier shall 31
consider, or request approval to consider, the results of 32
any genetic testing or the provision of genetic counseling 33
provided in accordance with this section in determining 34
eligibility for coverage, establishing premiums, limiting 35
coverage, renewing coverage, or any other underwriting 36
decision. A violation of this subsection shall constitute a 37
violation of section 375.1303. 38
4. No health benefit plan shall impose any cost- 39
sharing requirement with respect to coverage required under 40
this section. If application of this section would result 41
in health savings account ineligibility under Section 223 of 42
the Internal Revenue Code of 1986, as amended, this section 43
shall apply to health savings account-qualified high 44
deductible health plans with respect to any cost-sharing 45
under the plans only after an enrollee has satisfied the 46
minimum deductible under Section 223, except with respect to 47
items or services that are preventive care under Section 48
223(c)(2)(C) of the Internal Revenue Code of 1986, as 49
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amended, in which case the requirements of this section 50
shall apply regardless of whether the minimum deductible 51
under Section 223 has been satisfied. 52
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