CHAPTER 416

FORMERLY

HOUSE SUBSTITUTE NO. 1

FOR

HOUSE BILL NO. 564

AS AMENDED BY HOUSE AMENDMENT NO. 1 AND

SENATE AMENDMENT NO. 1

AN ACT TO AMEND TITLE 18 OF THE DELAWARE CODE RELATING TO COVERAGE FOR COLORECTAL CANCER SCREENING, HEALTH INSURANCE, AND GROUP AND BLANKET HEALTH INSURANCE.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE :

Section 1. Amend Chapter 33 of Title 18 of the Delaware Code by adding a new section thereto to read as follows:

Ҥ3344. Colorectal cancer screening.

(a) Every individual health, sickness or accident insurance policy contract or certificate, which is delivered or issued for delivery in this State by any health insurer, health service corporation or health maintenance organization shall provide coverage for colorectal cancer screening under any such policy, contract or plan delivered, issued for delivery or renewed in this State, on or after January 1, 2001. The terms ‘health, sickness or accident insurance policy contract or certificate’ shall not include, unless specifically provided in the policy, the following types of insurance or combination thereof: Accident only, fixed or hospital confinement indemnity, limited benefit, credit, vision, specified disease, Medicare supplement, Champus supplement, long term care, disability income workers compensation or automobile medical payment.

(b) Colorectal cancer screening covered by this section shall include:

(1) For persons 50 years of age or older: screening with annual fecal occult blood tests (three specimens), flexible sigmoidoscopy every five years, colonoscopy every ten years, double contrast barium enema every five years, or any combination of the most reliable, medically recognized screening tests available as may be determined by the Secretary of Health and Social Services of this State.

(2) For persons who are deemed at high risk for colon cancer because of:

a. family history of familial adenomatous polyposis;

b. family history of hereditary non-polyposis colon cancer;

c. chronic inflammatory bowel disease;

d. family history of breast, ovarian, endometrial, colon cancer or polyps; or

e. a background, ethnic or lifestyle, such that the health care provider treating the participant or beneficiary believes he or she is at elevated risk;

screening by colonoscopy, barium enema, or any combination of the most reliable, medically recognized screening tests available as determined by the Secretary of Health and Social Services of this State shall be covered at a frequency determined by the physician.”.

Section 2. Amend Chapter 35, Title 18, Delaware Code by adding a new section thereto to read as follows:

Ҥ 3559. Colorectal cancer screening.

(a) All group and blanket health insurance policies which are delivered or issued for delivery or renewed in this State on or after January 1, 2001 by any health insurer or health service corporation shall provide coverage for colorectal cancer screening.

(b) Colorectal cancer screening covered by this section shall include:

(1) For persons 50 years of age or older: screening with annual fecal occult blood tests (three specimens), flexible sigmoidoscopy every five years, colonoscopy every ten years, double contrast barium enema every five years, or any combination of the most reliable, medically recognized screening tests available as may be determined by the Secretary of Health and Social Services of this State.

(2) For persons who are deemed at high risk for colon cancer because of:

a. family history of familial adenomatous polyposis;

b. family history of hereditary non-polyposis colon cancer;

c. chronic inflammatory bowel disease;

d. family history of breast, ovarian, endometrial, colon cancer or polyps; or

e. a background, ethnic or lifestyle, such that the health care provider treating the participant or beneficiary believes he or she is at elevated risk;

screening by colonoscopy, barium enema, or any combination of the most reliable, medically recognized screening tests available as determined by the Secretary of Health and Social Services of this State shall be covered at a frequency determined by the physician.”.

Approved July 14, 2000