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Public Law
123rd Legislature
Second Regular Session
Chapter 516
H.P. 1495 - L.D. 2109
An Act Relating to Insurance Coverage for Colorectal Cancer Early Detection
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 24 MRSA §2317-B, sub-§12-C  is enacted to read:
 
12-C.  Title 24-A, sections 2763, 2847-N and 4254.     Coverage for colorectal cancer screening, Title 24-A, sections 2763, 2847-N and 4254; 
Sec. 2. 24-A MRSA §2763  is enacted to read:
§ 2763.  Coverage for colorectal cancer screening 
 
1.  Colorectal cancer screening.     For the purposes of this section, “colorectal cancer screening” means a colorectal cancer examination and laboratory test recommended by a health care provider in accordance with the most recently published colorectal cancer screening guidelines of a national cancer society. 
 
2.  Required coverage.     All individual health insurance policies and contracts must provide coverage for colorectal cancer screening for asymptomatic individuals who are: 
 
A.  Fifty years of age or older; or 
 
B.  Less than 50 years of age and at high risk for colorectal cancer according to the most recently published colorectal cancer screening guidelines of a national cancer society. 
 
3.  Billing.     If a colonoscopy is recommended by a health care provider as the colorectal cancer screening test in accordance with this section and a lesion is discovered and removed during that colonoscopy, the health care provider must bill the insurance company for a screening colonoscopy as the primary procedure. 
Sec. 3. 24-A MRSA §2847-N  is enacted to read:
§ 2847-N.  Coverage for colorectal cancer screening 
 
1.  Colorectal cancer screening.     For the purposes of this section, “colorectal cancer screening” means a colorectal cancer examination and laboratory test recommended by a health care provider in accordance with the most recently published colorectal cancer screening guidelines of a national cancer society. 
 
2.  Required coverage.     All group health insurance policies, contracts and certificates must provide coverage for colorectal cancer screening for asymptomatic individuals who are: 
 
A.  Fifty years of age or older; or 
 
B.  Less than 50 years of age and at high risk for colorectal cancer according to the most recently published colorectal cancer screening guidelines of a national cancer society. 
 
3.  Billing.     If a colonoscopy is recommended by a health care provider as the colorectal cancer screening test in accordance with this section and a lesion is discovered and removed during that colonoscopy, the health care provider must bill the insurance company for a screening colonoscopy as the primary procedure. 
§2847-N. Coverage for medically necessary infant formula
(As enacted by PL 2007, c. 595, §3 is REALLOCATED TO TITLE 24-A, SECTION 2847-P)
Sec. 4. 24-A MRSA §4254  is enacted to read:
§ 4254.  Coverage for colorectal cancer screening 
 
1.  Colorectal cancer screening.     For the purposes of this section, “colorectal cancer screening” means a colorectal cancer examination and laboratory test recommended by a health care provider in accordance with the most recently published colorectal cancer screening guidelines of a national cancer society. 
 
2.  Required coverage.     All health maintenance organization individual and group health insurance policies, contracts and certificates must provide coverage for colorectal cancer screening for asymptomatic individuals who are: 
 
A.  Fifty years of age or older; or 
 
B.  Less than 50 years of age and at high risk for colorectal cancer according to the most recently published colorectal cancer screening guidelines of a national cancer society. 
 
3.  Billing.     If a colonoscopy is recommended by a health care provider as the colorectal cancer screening test in accordance with this section and a lesion is discovered and removed during that colonoscopy, the health care provider must bill the insurance company for a screening colonoscopy as the primary procedure. 
§4254. Coverage for medically necessary infant formula
(As enacted by PL 2007, c. 595, §4 is REALLOCATED TO TITLE 24-A, SECTION 4256)
Sec. 5. Application. The requirements of this Act apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2009. For purposes of this Act, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.
Sec. 6. Exemption from review. Notwithstanding the Maine Revised Statutes, Title 24-A, section 2752, this Act is enacted without review and evaluation by the Department of Professional and Financial Regulation, Bureau of Insurance.
 
Effective June 30, 2008