[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[S. 710 Reported in Senate (RS)]






                                                       Calendar No. 555
107th CONGRESS
  2d Session
                                 S. 710

                          [Report No. 107-245]

         To require coverage for colorectal cancer screenings.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 5, 2001

  Mr. Kennedy (for himself, Mr. Helms, Mrs. Murray, Mr. Cochran, Mr. 
 Johnson, Mr. Miller, Ms. Snowe, Mr. Daschle, Ms. Cantwell, Mr. Kerry, 
 Mr. Reid, Mr. Brownback, Mr. Roberts, Ms. Landrieu, and Mr. Jeffords) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

                            August 28, 2002

 Reported under authority of the order of the Senate of July 29, 2002, 
                   by Mr. Kennedy, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 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,

<DELETED>SECTION 1. SHORT TITLE; FINDINGS.</DELETED>

<DELETED>    (a) Short Title.--This Act may be cited as the ``Eliminate 
Colorectal Cancer Act of 2001''.</DELETED>
<DELETED>    (b) Findings.--The Congress finds the following:</DELETED>
        <DELETED>    (1) Colorectal cancer is the second leading cause 
        of cancer deaths in the United States for men and women 
        combined.</DELETED>
        <DELETED>    (2) It is estimated that in 2001, 135,400 new 
        cases of colorectal cancer will be diagnosed in men and women 
        in the United States.</DELETED>
        <DELETED>    (3) Colorectal cancer is expected to kill 56,700 
        individuals in the United States in 2001.</DELETED>
        <DELETED>    (4) The adoption of a healthy lifestyle at a young 
        age can significantly reduce the risk of developing colorectal 
        cancer.</DELETED>
        <DELETED>    (5) Appropriate screenings and regular tests, can 
        save large numbers of lives by leading to earlier 
        identification of colorectal cancer.</DELETED>
        <DELETED>    (6) 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.</DELETED>
        <DELETED>    (7) Education helps to inform the public of 
        symptoms for the early detection of colorectal cancer and 
        methods of prevention.</DELETED>

<DELETED>SEC. 2. COVERAGE FOR COLORECTAL CANCER SCREENING.</DELETED>

<DELETED>    (a) Group Health Plans.--</DELETED>
        <DELETED>    (1) Public health service act amendments.--
        </DELETED>
                <DELETED>    (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:</DELETED>

<DELETED>``SEC. 2707. COVERAGE FOR COLORECTAL CANCER 
              SCREENING.</DELETED>

<DELETED>    ``(a) Coverage for Colorectal Cancer Screening.--
</DELETED>
        <DELETED>    ``(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--</DELETED>
                <DELETED>    ``(A) any participant or beneficiary age 
                50 or over; and</DELETED>
                <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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)).</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.''.</DELETED>
                <DELETED>    (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''.</DELETED>
        <DELETED>    (2) ERISA amendments.--</DELETED>
                <DELETED>    (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:</DELETED>

<DELETED>``SEC. 714. COVERAGE FOR COLORECTAL CANCER 
              SCREENING.</DELETED>

<DELETED>    ``(a) Coverage for Colorectal Cancer Screening.--
</DELETED>
        <DELETED>    ``(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--</DELETED>
                <DELETED>    ``(A) any participant or beneficiary age 
                50 or over; and</DELETED>
                <DELETED>    ``(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.</DELETED>
        <DELETED>    ``(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)).</DELETED>
        <DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.''.</DELETED>
                <DELETED>    (B) Technical and conforming amendments.--
                </DELETED>
                        <DELETED>    (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''.</DELETED>
                        <DELETED>    (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''.</DELETED>
                        <DELETED>    (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:</DELETED>

<DELETED>``Sec. 714. Coverage for colorectal cancer screening.''.
<DELETED>    (b) Individual Health Insurance.--</DELETED>
        <DELETED>    (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:</DELETED>

<DELETED>``SEC. 2753. COVERAGE FOR COLORECTAL CANCER 
              SCREENING.</DELETED>

<DELETED>    ``(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.</DELETED>
<DELETED>    ``(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.''.</DELETED>
        <DELETED>    (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''.</DELETED>
<DELETED>    (c) Effective Dates.--</DELETED>
        <DELETED>    (1) Group health plans.--</DELETED>
                <DELETED>    (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, 2002.</DELETED>
                <DELETED>    (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--</DELETED>
                        <DELETED>    (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</DELETED>
                        <DELETED>    (ii) January 1, 2002.</DELETED>
                <DELETED>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.</DELETED>
        <DELETED>    (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, 
2002.</DELETED>
<DELETED>    (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--</DELETED>
        <DELETED>    (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</DELETED>
        <DELETED>    (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.</DELETED>

SECTION 1. SHORT TITLE; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Eliminate 
Colorectal Cancer Act of 2002''.
    (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 2002, 148,300 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 2002.
            (4) The adoption of a healthy lifestyle at a young age can 
        significantly reduce the risk of developing colorectal cancer.
            (5) Appropriate screenings and regular tests, can save 
        large numbers of lives by leading to earlier identification of 
        colorectal cancer.
            (6) 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.
            (7) Education helps to inform the public of symptoms for 
        the early detection of colorectal cancer and methods of 
        prevention.
            (8) Too few American's are currently screened for 
        colorectal cancer according to widely accepted guidelines.
            (9) Assuring coverage for the full range of colorectal 
        cancer tests is an important step in increasing screening 
        rates.

SEC. 2. COVERAGE FOR COLORECTAL CANCER SCREENING.

    (a) Group Health Plans.--
            (1) Public health service act amendments.--The Public 
        Health Service Act (42 U.S.C. 201 et seq.) is amended by adding 
        at the end the following:

              ``TITLE XXIX--MISCELLANEOUS HEALTH COVERAGE

``SEC. 2901. 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 age 50 or 
                over; and
                    ``(B) any participant or beneficiary under the age 
                of 50 who is at a high risk for colorectal cancer.
            ``(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) Requirement for screening.--The group health plan or 
        health insurance issuer shall cover methods of colorectal 
        cancer screening that--
                    ``(A) are deemed appropriate by a physician (as 
                defined in section 1861(r) of the Social Security Act 
                (42 U.S.C. 1395x(r))) treating the participant or 
                beneficiary, in consultation with the participant or 
                beneficiary;
                    ``(B) are--
                            ``(i) described in section 1861(pp)(1) of 
                        the Social Security Act (42 U.S.C. 
                        1395x(pp)(1)) or section 410.37 of title 42, 
                        Code of Federal Regulations; or
                            ``(ii) specified by the Secretary, based 
                        upon the recommendations of appropriate 
                        organizations with special expertise in the 
                        field of colorectal cancer; and
                    ``(C) are performed at a frequency not greater than 
                that--
                            ``(i) described for such method in section 
                        1834(d) of the Social Security Act (42 U.S.C. 
                        1395m(d)) or section 410.37 of title 42, Code 
                        of Federal Regulations; or
                            ``(ii) specified by the Secretary for such 
                        method, if the Secretary finds, based upon new 
                        scientific knowledge and consistent with the 
                        recommendations of appropriate organizations 
                        with special expertise in the field of 
                        colorectal cancer, that a different frequency 
                        would not adversely affect the effectiveness of 
                        such screening.
    ``(b) Notice.--A group health plan under this section 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.
    ``(d) Definitions and Enforcement.--The definitions and enforcement 
provisions of title XXVII shall apply for purposes of this section.''.
            (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 age 50 or 
                over; and
                    ``(B) any participant or beneficiary under the age 
                of 50 who is at a high risk for colorectal cancer.
            ``(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) Requirement for screening.--The group health plan or 
        health insurance issuer shall cover methods of colorectal 
        cancer screening that--
                    ``(A) are deemed appropriate by a physician (as 
                defined in section 1861(r) of the Social Security Act 
                (42 U.S.C. 1395x(r))) treating the participant or 
                beneficiary, in consultation with the participant or 
                beneficiary;
                    ``(B) are--
                            ``(i) described in section 1861(pp)(1) of 
                        the Social Security Act (42 U.S.C. 
                        1395x(pp)(1)) or section 410.37 of title 42, 
                        Code of Federal Regulations; or
                            ``(ii) specified by the Secretary, based 
                        upon the recommendations of appropriate 
                        organizations with special expertise in the 
                        field of colorectal cancer; and
                    ``(C) are performed at a frequency not greater than 
                that--
                            ``(i) described for such method in section 
                        1834(d) of the Social Security Act (42 U.S.C. 
                        1395m(d)) or section 410.37 of title 42, Code 
                        of Federal Regulations; or
                            ``(ii) specified by the Secretary for such 
                        method, if the Secretary finds, based upon new 
                        scientific knowledge and consistent with the 
                        recommendations of appropriate organizations 
                        with special expertise in the field of 
                        colorectal cancer, that a different frequency 
                        would not adversely affect the effectiveness of 
                        such screening.
    ``(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 2901(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.--The amendments made by subsection 
        (a) shall apply with respect to group health plans for plan 
        years beginning on or after January 1, 2003.
            (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, 2003.
    (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.




                                                       Calendar No. 555

107th CONGRESS

  2d Session

                                 S. 710

                          [Report No. 107-245]

_______________________________________________________________________

                                 A BILL

         To require coverage for colorectal cancer screenings.

_______________________________________________________________________

                            August 28, 2002

                       Reported with an amendment