[Congressional Record Volume 147, Number 49 (Thursday, April 5, 2001)]
[Senate]
[Pages S3537-S3539]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KENNEDY (for himself and Mr. Helms):
  S. 710. A bill to require coverage for colorectal cancer screenings; 
to the Committee on Health, Education, Labor, and Pensions.
  Mr. KENNEDY. Mr. President, today, I am introducing the ``Eliminate 
Colorectal Cancer Act of 2001''. I am pleased to have my colleague, 
Senator Helms, as the leading co-sponsor of this important legislation.
  Colorectal cancer is the second leading cause of cancer deaths among 
men and women in America. Over 50,000 Americans will die of this 
disease this year alone.
  The good news on colorectal cancer is that if it is detected early, 
we can dramatically improve the chance of survival. We have tried and 
true screening techniques that can not only discover this cancer early, 
but can prevent this disease by finding and eliminating growths before 
they become cancerous.
  The tragedy is that too often Americans do not get these lifesaving 
screenings. Today, only one-third of those at-risk for colorectal 
cancer are screened--and screening rates for minorities and women are 
even lower. All Americans age 50 and over should be screened for this 
disease, and there are many at increased risk who may need to start 
screening even earlier.

[[Page S3538]]

  Some are simply not aware they should be screened and others cannot 
afford to get this lifesaving test. We must work together for the day 
when no American is denied access to these lifesaving screening 
procedures simply because their health insurance company would not foot 
the bill.
  Medicare offers this important benefit. Now it's time that every 
American has that same assurance.
  That is why this week we are introducing ``The Eliminate Colorectal 
Cancer Act of 2001'', bipartisan legislation that will ensure that all 
health insurance covers screening procedures that can discover 
colorectal cancer in its earliest and most treatable stages.
  I am pleased that Representative Slaughter and Representative Morella 
are offering a similar bipartisan bill in the House, and I express my 
appreciation of so many from the cancer community on this legislation 
over the past couple of years.
  In this case, an ounce of prevention brings a lifesaving cure that 
could save tens of thousands of lives this year.
  I ask unanimous consent that the text of the ``Eliminate Colorectal 
Cancer Act of 2001'' be printed in the Record with a bill summary.
  There being no objection, the additional material was ordered to be 
printed in the Record, as follows:

                                 S. 710

       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 2001''.
       (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 2001, 135,400 new cases of 
     colorectal cancer will be diagnosed in men and women in the 
     United States.
       (3) Colorectal cancer is expected to kill 56,700 
     individuals in the United States in 2001.
       (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.

     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:

     ``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 age 50 or over; 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 age 50 or over; 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, 2002.
       (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, 2002.
     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

[[Page S3539]]

     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.
       (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.
                                  ____


                Eliminate Colorectal Cancer Act of 2001


                     endorsements and bill summary

       Colorectal cancer is the second leading cause of cancer 
     deaths among men and women. Each year, more than 56,000 
     Americans die from this devastating disease, yet colorectal 
     cancer can be easily prevented or treated when it is 
     diagnosed early through regular, appropriate screening tests. 
     Unfortunately, only one-third of the at-risk United States 
     population is currently screened for colorectal cancer. In 
     the Balanced Budget Act of 1997, Congress acted to encourage 
     more screening by creating a new colorectal cancer screening 
     benefit for Medicare beneficiaries. We believe the time has 
     come for persons under age 65.
       The Eliminate Colorectal Cancer Act of 2001 would require 
     all health insurance plans to cover colorectal cancer 
     screening for all patients age 50 and over and for others who 
     have significant risk factors for the disease. The screening 
     method and frequency of the test would be based on the 
     patient's medical condition and decided by the treating 
     physician, in consultation with the patient. Methods covered 
     under the Act are those that are available under Medicare.
       As colorectal cancer survivors in every state will attest, 
     early detection and treatment are essential to winning this 
     battle. More than 90 percent of people whose colorectal 
     cancer is detected and treated early are able to resume 
     active and productive lives.
       This legislation is strongly supported by these and many 
     other leading organizations:
       American Cancer Society, American Gastroenterological 
     Association, Cancer Research Foundation of America, American 
     Association for Clinical Chemistry, Digestive Disease 
     National Coalition, Association of Community Cancer Centers, 
     American Association of Homes and Services for the Aging, 
     American College of Gastroenterology, American Society for 
     Gastrointestinal Endoscopy, Colon Cancer Alliance, Hereditary 
     Colon Cancer Association, Crohn's and Colitis Foundation of 
     America, Men's Health Network, Cancercare, Society for 
     Gastroenterological Nurses and Associates.
                                 ______