[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[S. 1044 Introduced in Senate (IS)]







106th CONGRESS
  1st Session
                                S. 1044

         To require coverage for colorectal cancer screenings.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 13, 1999

  Mr. Kennedy introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 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) In general.--Subpart 2 of part A of title XXVII 
                of the Public Health Service Act (42 U.S.C. 300gg-4 et 
                seq.) 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) Technical amendment.--Section 2723(c) of the 
                Public Health Service Act (42 U.S.C. 300gg-23(c)) is 
                amended by striking ``section 2704'' and inserting 
                ``sections 2704 and 2707''.
            (2) ERISA amendments.--
                    (A) In general.--Subpart B of part 7 of subtitle B 
                of title I of the Employee Retirement Income Security 
                Act of 1974 (29 U.S.C. 1185 et seq.) 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) Technical and conforming amendments.--
                            (i) Section 731(c) of the Employee 
                        Retirement Income Security Act of 1974 (29 
                        U.S.C. 1191(c)) is amended by striking 
                        ``section 711'' and inserting ``sections 711 
                        and 714''.
                            (ii) Section 732(a) of the Employee 
                        Retirement Income Security Act of 1974 (29 
                        U.S.C. 1191a(a)) is amended by striking 
                        ``section 711'' and inserting ``sections 711 
                        and 714''.
                            (iii) The table of contents in section 1 of 
                        the Employee Retirement Income Security Act of 
                        1974 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) In general.--Part B of title XXVII of the Public Health 
        Service Act (42 U.S.C. 300gg-41 et seq.) 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.''.
            (2) Technical amendment.--Section 2762(b)(2) of the Public 
        Health Service Act (42 U.S.C. 300gg-62(b)(2)) is amended by 
        striking ``section 2751'' and inserting ``sections 2751 and 
        2753''.
    (c) Effective Dates.--
            (1) Group health plans.--
                    (A) In general.--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) Collective bargaining agreements.--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) Individual health insurance.--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.
    (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.
                                 <all>