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1999 SESSION

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HB 2354 Health insurance; coverage of certain pap smears.

Introduced by: Gladys B. Keating | all patrons    ...    notes | add to my profiles | history

SUMMARY AS PASSED:

Accident and sickness insurance; coverage of certain pap smears. Requires the state employees’ health plan, health insurers, health services plans and HMOs, when providing coverage for pap smears (a mandated benefit), to provide coverage for testing performed by any FDA-approved gynecologic cytology screening technologies.

SUMMARY AS PASSED HOUSE:

Accident and sickness insurance; coverage of certain pap smears. Requires health insurers, health services plans and HMOs when providing coverage for pap smears (a mandated benefit), to provide coverage for testing performed by any FDA-approved gynecologic cytology screening technologies.

SUMMARY AS INTRODUCED:

Accident and sickness insurance; coverage of certain pap smears. Requires each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services which was already required to provide coverage under such policy, contract or plan delivered, issued for delivery or renewed in this Commonwealth on and after July 1, 1996, for annual pap smears, to include coverage, on and after July 1, 1999, for annual ThinPrep pap tests. When calculating the reimbursement for the ThinPrep pap test, consideration must be given to cost savings realized or likely to be realized as a consequence of early identification and treatment of disease; such calculations cannot be based solely on the costs per year of lives saved. The ThinPrep pap test, which is said to identify 55 percent more precancerous conditions, costs approximately $15 more than a traditional pap smear. Although the ThinPrep pap test may be reimbursed by some companies, the level of reimbursement is the same as the traditional pap smear, which effectively eliminates availability of this test. The bill contains a technical amendment.