AUTHOR'S / SPONSOR'S STATEMENT OF INTENT
Interested parties note that the high mortality rate for women with ovarian cancer is largely because the disease has vague symptoms and that the manifestation of the disease is not recognized until it is too late. The parties note that this is compounded by the circumstance that women are not regularly screened for the disease in the same manner as for cervical cancer and breast cancer. These factors result in the disease being diagnosed almost always at an advanced stage, making it very difficult to successfully treat. However, early detection and intervention can significantly increase the odds of permanent remission. Interested parties contend that the CA 125 blood test is a promising diagnostic tool, especially when used in conjunction with an ultrasound if the CA 125 is found to be elevated, indicating the possible presence of ovarian cancer. H.B. 2813 seeks to address these concerns by improving ovarian cancer screening practices.
H.B. 2813 amends current law relating to health benefit plan coverage for ovarian cancer screening.
RULEMAKING AUTHORITY
This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends the heading to Chapter 1370, Insurance Code, to read as follows:
CHAPTER 1370. CERTAIN TESTS FOR DETECTION OF HUMAN PAPILLOMAVIRUS, OVARIAN CANCER, AND CERVICAL CANCER
SECTION 2. Amends Section 1370.002, Insurance Code, as follows:
Sec. 1370.002. New heading; EXCEPTIONS. (a) Creates this subsection from existing text and makes no further change.
(b) Provides that this chapter does not apply to a qualified health plan if a determination is made under 45 C.F.R. Section 155.170 that this chapter requires the plan to offer benefits in addition to the essential health benefits required under 42 U.S.C. Section 18022(b) and that this state is required to defray the cost of the benefits mandated under this chapter.
SECTION 3. Amends Sections 1370.003(a) and (b), Insurance Code, as follows:
(a) Requires that a health benefit plan that provides coverage for diagnostic medical procedures provide to each woman 18 years of age or older enrolled in the plan coverage for expenses for an annual medically recognized diagnostic examination for the early detection of ovarian cancer and cervical cancer.
(b) Requires that coverage required under this section includes at a minimum:
(1) a CA 125 blood test; and
(2) Creates this subdivision from existing text. Makes no further change to this subdivision.
SECTION 4. Provides that the change in law made by this Act applies only to a health benefit plan that is delivered, issued for delivery, or renewed on or after the effective date of this Act. Makes application of this Act prospective.
SECTION 5. Effective date: September 1, 2015.