New Jersey A 3523: Requires health insurers to cover colorectal cancer screenings recommended by United States Preventive Services Task Force and eliminates cost-sharing requirements for certain colonoscopies.

Bill Text

(Sponsorship Updated As Of: 12/19/2022)
ASSEMBLY, No. 3523

STATE OF NEW JERSEY
220th LEGISLATURE

INTRODUCED MARCH 8, 2022

Sponsored by:
Assemblyman DANIEL R. BENSON
District 14 (Mercer and Middlesex)
Assemblyman STERLEY S. STANLEY
District 18 (Middlesex)
Assemblyman HERB CONAWAY, JR.
District 7 (Burlington)
Senator VIN GOPAL
District 11 (Monmouth)
Senator LINDA R. GREENSTEIN
District 14 (Mercer and Middlesex)

Co-Sponsored by:
Assemblywomen Chaparro, Sumter, Timberlake, Speight, Assemblymen
Danielsen, Mejia, Verrelli, Calabrese, Karabinchak, Spearman, Tully,
Assemblywoman Swain, Assemblymen Catalano, Moriarty,
Assemblywomen Piperno, Eulner, Assemblyman Moen, Assemblywomen
Matsikoudis, DeFuccio, Assemblyman Auth, Assemblywomen Park,
Murphy, Reynolds-Jackson, Assemblymen Rooney, Freiman,
Assemblywomen McKnight, Lopez, Quijano, Senators Corrado, Codey,
Diegnan, Madden, Lagana, Zwicker, A.M.Bucco, Cryan, Holzapfel,
Schepisi, Singer, Bramnick, Pou and Turner

SYNOPSIS
Requires health insurers to cover colorectal cancer screenings recommended
by United States Preventive Services Task Force and eliminates cost-sharing
requirements for certain colonoscopies.

CURRENT VERSION OF TEXT
As introduced.

A3523 BENSON, STANLEY
2

EXPLANATION – Matter enclosed in bold-faced brackets [thus] in the above bill is
not enacted and is intended to be omitted in the law.

Matter underlined thus is new matter.

AN ACT concerning health benefits for colorectal cancer screenings, 1
and amending and supplementing various parts of the statutory 2
law. 3
4
BE IT ENACTED by the Senate and General Assembly of the State 5
of New Jersey: 6
7
1. Section 1 of P.L.2001, c.295 (C.17:48-6y) is amended to 8
read as follows: 9
1. a. Every hospital service corporation contract that provides 10
hospital or medical expense benefits and is delivered, issued, 11
executed or renewed in this State pursuant to P.L.1938, c.366 12
(C.17:48-1 et seq.), or approved for issuance or renewal in this State 13
by the Commissioner of Banking and Insurance on or after the 14
effective date of this act, shall provide benefits to any named 15
subscriber or other person covered thereunder for expenses incurred 16
in conducting a colorectal cancer screening [at regular intervals for 17
persons age 50 and over and for persons of any age who are 18
considered to be at high risk for colorectal cancer. The methods of 19
screening for which benefits shall be provided shall include: a 20
screening fecal occult blood test, flexible sigmoidoscopy, 21
colonoscopy, barium enema, or any combination thereof; or the 22
most reliable, medically recognized screening test available] in 23
accordance with United States Preventive Services Task Force 24
recommendations. The method and frequency of screening to be 25
utilized shall be in accordance with the most [recent] recently 26
published [guidelines] recommendations of the [American Cancer 27
Society] United States Preventive Services Task Force and as 28
determined medically necessary by the covered person’s physician, 29
in consultation with the covered person. 30
[As used in this section, “high risk for colorectal cancer” means 31
a person has: 32
a. a family history of: familial adenomatous polyposis; 33
hereditary non-polyposis colon cancer; or breast, ovarian, 34
endometrial or colon cancer or polyps; 35
b. chronic inflammatory bowel disease; or 36
c. a background, ethnicity or lifestyle that the physician 37
believes puts the person at elevated risk for colorectal cancer.] 38
b. No deductible, coinsurance, copayment, or any other cost-39
sharing requirement shall be imposed for a colonoscopy performed 40
following a positive result on a non-colonoscopy, colorectal cancer 41
screening test recommended by the United States Preventive 42
Services Task Force. 43
c. The benefits shall be provided to the same extent as for any 44
other medical condition under the contract. 45

A3523 BENSON, STANLEY
3

d. The provisions of this section shall apply to all hospital 1
service corporation contracts in which the hospital service 2
corporation has reserved the right to change the premium. 3
(cf: P.L.2001, c.295, s.1) 4
5
2. Section 2 of P.L.2001, c.295 (C.17:48A-7x) is amended to 6
read as follows: 7
2. a. Every medical service corporation contract that provides 8
hospital or medical expense benefits and is delivered, issued, 9
executed or renewed in this State pursuant to P.L.1940, c.74 10
(C.17:48A-1 et seq.), or approved for issuance or renewal in this 11
State by the Commissioner of Banking and Insurance on or after the 12
effective date of this act, shall provide benefits to any named 13
subscriber or other person covered thereunder for expenses incurred 14
in conducting a colorectal cancer screening [at regular intervals for 15
persons age 50 and over and for persons of any age who are 16
considered to be at high risk for colorectal cancer. The methods of 17
screening for which benefits shall be provided shall include: a 18
screen