An Act Relating to Insurance Coverage for Colorectal Cancer Early Detection
Maine Legislature, Session 123, LD 2109
Committee Amendment CA_A_H697 (House)
Amends: 24-A MRSA §2763, 24-A MRSA §4254

COMMITTEE AMENDMENT "J1 " to H.P. 1495, L.D. 2109, Bill, "An Act 
Relating to Insurance Coverage for Colorectal Cancer Early Detection" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 24 MRS A §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 
I 
company for a screening colonoscopy as the primary procedure. 
Sec. 3. 24-A MRS A §2847-N is enacted to read: 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" ~" to H.P. 1495, L.D. 2109 
§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. 
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. 
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.' 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT .. A 
"to H.P. 1495, L.D. 2109 
SUMMARY 
This amendment replaces the bill and is the majority report of the committee. The 
amendment requires health insurance policies, contracts and certificates to provide 
coverage for colorectal cancer screening recommended by health care providers in 
accordance with guidelines published by the American Cancer Society. The amendment 
clarifies that, if a colonoscopy is provided as the screening procedure and a lesion is 
discovered and removed, the health care provider must bill the insurer for a screening 
colonoscopy as the primary procedure. The provisions of the amendment apply to all 
policies, contracts and certificates issued or renewed on or after January 1,2009. 
FISCAL NOTE REQUIRED 
1 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 02/14/08 
~ac:.. 
LD 2109 
LR 2805(02) 
An Act Relating to Insurance Coverage for Colorectal Cancer Early Detection 
Fiscal Note for Bill as Amended by Committee Amendment" A" 
Committee: Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - Other Special Revenue Funds 
Fiscal Detail and Notes 
Any additional cost to the Bureau of Insurance in the Department of Professional and Financial Regulation can be 
absorbed by the bureau utilizing existing budget resources. No impact on the State Employee Health Plan is expecter 
LR2805(02) - Fiscal Note - Page 1 of 1