Missouri SB 406: Enacts provisions relating to insurance coverage of genetic screenings for cancer risk

Bill Text

FIRST REGULAR SESSION
SENATE BILL NO. 406
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR MOSLEY.
0041S.01I KRISTINA MARTIN, Secretary
AN ACT
To amend chapter 376, RSMo, by adding thereto one new section relating to insurance coverage
of genetic screenings for cancer risk.

Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 376, RSMo, is amended by adding thereto 1
one new section, to be known as section 376.1260, to read as 2
follows:3
376.1260. 1. As used in this section, the following 1
terms mean: 2
(1) "Cost-sharing requirement", any deductible, 3
coinsurance, co-payment, or maximum limitation on the 4
application of such deductible, coinsurance, co-payment, or 5
similar out-of-pocket expense; 6
(2) "Genetic counseling", the provision of services to 7
individuals, couples, families, and organizations by one or 8
more appropriately trained individuals to address the 9
physical and psychological issues associated with the 10
occurrence or risk of occurrence of a genetic disorder, 11
birth defect, or genetically influenced condition or disease 12
in an individual or a family; 13
(3) "Health benefit plan", the same meaning as is 14
ascribed to such term in section 376.1350; 15
(4) "Health carrier", the same meaning as is ascribed 16
to such term in section 376.1350. 17

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2. Each health benefit plan delivered, issued for 18
delivery, continued or renewed on or after January 1, 2025, 19
shall provide coverage for BRCA-related genetic counseling 20
and genetic testing provided by an individual certified by 21
an accrediting body, recognized by the department of 22
commerce and insurance, to provide genetic counseling and 23
genetic testing. The coverage required under this section 24
shall include all costs associated with genetic counseling 25
and, if indicated after genetic counseling, a genetic 26
laboratory test of the BRCA1 and BRCA2 genes for individuals 27
assessed to be at an increased risk, based on a clinical 28
risk assessment tool, of potentially harmful mutations in 29
the BRCA1 or BRCA2 genes due to a personal or family history 30
of breast or ovarian cancer. 31
3. No health benefit plan or health carrier shall 32
consider, or request approval to consider, the results of 33
any genetic testing or the provision of genetic counseling 34
provided in accordance with this section in determining 35
eligibility for coverage, establishing premiums, limiting 36
coverage, renewing coverage, or any other underwriting 37
decision. A violation of this subsection shall constitute a 38
violation of section 375.1303. 39
4. No health benefit plan shall impose any cost- 40
sharing requirement with respect to coverage required under 41
this section. If application of this section would result 42
in health savings account ineligibility under Section 223 of 43
the Internal Revenue Code of 1986, as amended, this section 44
shall apply to health savings account-qualified high 45
deductible health plans with respect to any cost-sharing 46
under the plans only after an enrollee has satisfied the 47
minimum deductible under Section 223, except with respect to 48
items or services that are preventive care under Section 49

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223(c)(2)(C) of the Internal Revenue Code of 1986, as 50
amended, in which case the requirements of this section 51
shall apply regardless of whether the minimum deductible 52
under Section 223 has been satisfied. 53
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