I 
108TH CONGRESS 
2D SESSION 
H. R. 4097 
To require group and individual health plans to provide coverage for colorectal 
cancer screenings. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 31, 2004 
Ms. SLAUGHTER (for herself and Mr. KING of New York) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Education and the Work-
force, 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 group and individual health plans to provide 
coverage for colorectal cancer screenings. 
Be it enacted by the Senate and House of Representa-
tives 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 2004’’. 
(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 2004, 146,940 new 
cases of colorectal cancer will be diagnosed in men 
and women in the United States. 
(3) Colorectal cancer is expected to kill 56,730 
individuals in the United States in 2004. 
(4) When colorectal cancer is diagnosed early, 
at a localized stage, more than 90 percent of pa-
tients survive for 5 years or more. Once the disease 
has metastasized, 92 percent of patients die within 
5 years. Yet, only 37 percent of colorectal cancer 
cases are diagnosed while the disease is still in the 
localized stage. 
(5) If all men and women age 50 and over prac-
ticed regular colorectal cancer screening, without 
any new scientific discoveries, the United States 
could see up to a 50 to 90 percent reduction in 
deaths from this disease. 
(6) Currently, many private insurance health 
plans are not providing coverage for the full range 
of colorectal cancer screening tests. Lack of insur-
ance coverage can act as a barrier to care.
(7) Assuring coverage for the full range of 
colorectal cancer tests is an important step in in-
creasing screening rates for these life saving tests. 
SEC. 2. COVERAGE FOR COLORECTAL CANCER SCREENING. 
(a) GROUP HEALTH PLANS.— 
(1) PUBLIC
HEALTH
SERVICE
ACT
AMEND-
MENTS.—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 SCREEN-
ING. 
‘‘(a) COVERAGE FOR COLORECTAL CANCER SCREEN-
ING.— 
‘‘(1) IN GENERAL.—A group health plan, and a 
health insurance issuer offering group health insur-
ance coverage, shall provide coverage for colorectal 
cancer screening consistent with this subsection 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 physi-
cian (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 sec-
tion 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 con-
sistent with the recommendations of appro-
priate organizations with special expertise 
in the field of colorectal cancer, that a dif-
ferent frequency would not adversely affect 
the effectiveness of such screening. 
‘‘(b) NOTICE.—A group health plan under this sec-
tion shall comply with the notice requirement under sec-
tion 714(b) of the Employee Retirement Income Security 
Act of 1974 with respect to the requirements of this sec-
tion 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 super-
sede any provision of State law which establishes, imple-
ments, or continues in effect any standard or requirement 
solely relating to health insurance issuers in connection 
with group health insurance coverage that provides great-