[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1816 Introduced in House (IH)]







106th CONGRESS
  1st Session
                                H. R. 1816

         To require coverage for colorectal cancer screenings.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 13, 1999

Ms. Slaughter (for herself, Mrs. Morella, Mr. Sisisky, and Mr. Hastings 
 of Florida) introduced the following bill; which was referred to the 
 Committee on Commerce, and in addition to the Committee on Education 
 and the Workforce, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
         To require coverage for colorectal cancer screenings.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Eliminate 
Colorectal Cancer Act of 1999''.
    (b) Findings.--The Congress finds the following:
            (1) Colorectal cancer is the second leading cause of cancer 
        deaths in the United States for men and women combined.
            (2) It is estimated that in 1999, 129,400 new cases of 
        colorectal cancer will be diagnosed in men and women in the 
        United States.
            (3) Colorectal cancer is expected to kill 56,600 
        individuals in the United States in 1999.
            (4) Research has shown that a high-fiber, low-fat diet can 
        significantly reduce the risk of developing colorectal cancer.
            (5) The adoption of a healthy diet at a young age can 
        significantly reduce the risk of developing colorectal cancer.
            (6) Appropriate screenings and regular tests can save large 
        numbers of lives by leading to earlier identification of 
        colorectal cancer.
            (7) The Centers for Disease Control and Prevention, the 
        Health Care Financing Administration, and the National Cancer 
        Institute have initiated the Screen for Life Campaign targeted 
        to individuals age 50 and older to spread the message of the 
        importance of colorectal cancer screening tests.
            (8) Education helps to inform the public of symptoms for 
        the early detection of colorectal cancer and methods of 
        prevention.

SEC. 2. COVERAGE FOR COLORECTAL CANCER SCREENING.

    (a) Group Health Plans.--
            (1) Public health service act amendments.--(A) Subpart 2 of 
        part A of title XXVII of the Public Health Service Act is 
        amended by adding at the end the following new section:

``SEC. 2707. COVERAGE FOR COLORECTAL CANCER SCREENING.

    ``(a) Coverage for Colorectal Cancer Screening.--
            ``(1) In general.--A group health plan, and a health 
        insurance issuer offering group health insurance coverage, 
        shall provide coverage for colorectal cancer screening at 
        regular intervals to--
                    ``(A) any participant or beneficiary over the age 
                of 50; and
                    ``(B) any participant or beneficiary under the age 
                of 50 who is at a high risk for colorectal cancer, or 
                who may have symptoms or circumstances that indicate a 
need for colorectal cancer screening.
            ``(2) Definition of high risk.--For purposes of subsection 
        (a)(1)(B), the term `high risk for colorectal cancer' has the 
        meaning given such term in section 1861(pp)(2) of the Social 
        Security Act (42 U.S.C. 1395x(pp)(2)).
            ``(3) Method of screening.--The group health plan or health 
        insurance issuer shall cover the method and frequency of 
        colorectal cancer screening deemed appropriate by a health care 
        provider treating such participant or beneficiary, in 
        consultation with the participant or beneficiary. Such coverage 
        shall include the procedures in section 1861(pp)(1) of the 
        Social Security Act (42 U.S.C. 1395x(pp)(1)) and section 
        4104(a)(2) of the Balanced Budget Act of 1997.
    ``(b) Notice.--A group health plan under this part shall comply 
with the notice requirement under section 714(b) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
of this section as if such section applied to such plan.
    ``(c) Non-Preemption of More Protective State Law With Respect to 
Health Insurance Issuers.--This section shall not be construed to 
supersede any provision of State law which establishes, implements, or 
continues in effect any standard or requirement solely relating to 
health insurance issuers in connection with group health insurance 
coverage that provides greater protections to participants and 
beneficiaries than the protections provided under this section.''.
            (B) Section 2723(c) of such Act (42 U.S.C. 300gg-23(c)) is 
        amended by striking ``section 2704'' and inserting ``sections 
        2704 and 2707''.
            (2) ERISA amendments.--(A) Subpart B of part 7 of subtitle 
        B of title I of the Employee Retirement Income Security Act of 
        1974 is amended by adding at the end the following new section:

``SEC. 714. COVERAGE FOR COLORECTAL CANCER SCREENING.

    ``(a) Coverage for Colorectal Cancer Screening.--
            ``(1) In general.--A group health plan, and a health 
        insurance issuer offering group health insurance coverage, 
        shall provide coverage for colorectal cancer screening at 
        regular intervals to--
                    ``(A) any participant or beneficiary over the age 
                of 50; and
                    ``(B) any participant or beneficiary under the age 
                of 50 who is at a high risk for colorectal cancer, or 
                who may have symptoms or circumstances that indicate a 
                need for colorectal cancer screening.
            ``(2) Definition of high risk.--For purposes of subsection 
        (a)(1)(B), the term `high risk for colorectal cancer' has the 
        meaning given such term in section 1861(pp)(2) of the Social 
        Security Act (42 U.S.C. 1395x(pp)(2)).
            ``(3) Method of screening.--The group health plan or health 
        insurance issuer shall cover the method and frequency of 
        colorectal cancer screening deemed appropriate by a health care 
        provider treating such participant or beneficiary, in 
        consultation with the participant or beneficiary. Such coverage 
        shall include the procedures in section 1861(pp)(1) of the 
        Social Security Act (42 U.S.C. 1395x(pp)(1)) and section 
        4104(a)(2) of the Balanced Budget Act of 1997.
    ``(b) Notice Under Group Health Plan.--The imposition of the 
requirements of this section shall be treated as a material 
modification in the terms of the plan described in section 102(a), for 
purposes of assuring notice of such requirements under the plan; except 
that the summary description required to be provided under the third to 
last sentence of section 104(b)(1) with respect to such modification 
shall be provided by not later than 60 days after the first day of the 
first plan year in which such requirements apply.''.
            (B) Section 731(c) of such Act (29 U.S.C. 1191(c)) is 
        amended by striking ``section 711'' and inserting ``sections 
        711 and 714''.
            (C) Section 732(a) of such Act (29 U.S.C. 1191a(a)) is 
        amended by striking ``section 711'' and inserting ``sections 
        711 and 714''.
            (D) The table of contents in section 1 of such Act is 
        amended by inserting after the item relating to section 713 the 
        following new item:

``Sec. 714. Coverage for colorectal cancer screening.''.
    (b) Individual Health Insurance.--(1) Part B of title XXVII of the 
Public Health Service Act is amended by inserting after section 2752 
the following new section:

``SEC. 2753. COVERAGE FOR COLORECTAL CANCER SCREENING.

    ``(a) In General.--The provisions of section 2707(a) shall apply to 
health insurance coverage offered by a health insurance issuer in the 
individual market in the same manner as it applies to health insurance 
coverage offered by a health insurance issuer in connection with a 
group health plan in the small or large group market.
    ``(b) Notice.--A health insurance issuer under this part shall 
comply with the notice requirement under section 714(b) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
referred to in subsection (a) as if such section applied to such issuer 
and such issuer were a group health plan.''.
    (c) Effective Dates.--(1)(A) Subject to subparagraph (B), the 
amendments made by subsection (a) shall apply with respect to group 
health plans for plan years beginning on or after January 1, 2001.
    (B) In the case of a group health plan maintained pursuant to 1 or 
more collective bargaining agreements between employee representatives 
and 1 or more employers ratified before the date of enactment of this 
Act, the amendments made by subsection (a) shall not apply to plan 
years beginning before the later of--
            (i) the date on which the last collective bargaining 
        agreements relating to the plan terminates (determined without 
        regard to any extension thereof agreed to after the date of 
        enactment of this Act), or
            (ii) January 1, 2001.
For purposes of clause (i), any plan amendment made pursuant to a 
collective bargaining agreement relating to the plan which amends the 
plan solely to conform to any requirement added by subsection (a) shall 
not be treated as a termination of such collective bargaining 
agreement.
    (2) The amendments made by subsection (b) shall apply with respect 
to health insurance coverage offered, sold, issued, renewed, in effect, 
or operated in the individual market on or after January 1, 2001.
    (3) The amendment made by subsection (c) shall apply to contracts 
for contract periods beginning on or after January 1, 2001.
    (d) Coordinated Regulations.--The Secretary of Labor and the 
Secretary of Health and Human Services shall ensure, through the 
execution of an interagency memorandum of understanding among such 
Secretaries, that--
            (1) regulations, rulings, and interpretations issued by 
        such Secretaries relating to the same matter over which both 
        Secretaries have responsibility under the provisions of this 
        section (and the amendments made thereby) are administered so 
        as to have the same effect at all times; and
            (2) coordination of policies relating to enforcing the same 
        requirements through such Secretaries in order to have a 
        coordinated enforcement strategy that avoids duplication of 
        enforcement efforts and assigns priorities in enforcement.

SEC. 3. SENSE OF THE CONGRESS.

    It is the sense of the Congress that--
            (1) all Americans should be educated about the risks, 
        prevention, screening, and treatment of colorectal cancer;
            (2) the Centers for Disease Control and Prevention and the 
        Department of Health and Human Services should be commended for 
        launching a coordinated education campaign on colorectal cancer 
        in March of 1999; and
            (3) the Centers for Disease Control and Prevention and the 
        Department of Health and Human Services should track the impact 
        of the coordinated education campaign on colorectal cancer and 
        make information on its progress available to Members of 
        Congress.
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