HF 2414

as introduced - 92nd Legislature (2021 - 2022) Posted on 03/17/2022 05:20pm

A bill for an act
relating to health insurance; increasing availability and coverage for testing and
diagnostic services related to breast cancer; amending Minnesota Statutes 2020,
sections 62A.30, subdivisions 2, 4; 256B.0625, subdivision 14.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2020, section 62A.30, subdivision 2, is amended to read:

Subd. 2.

Required coverage.

new text begin (a) new text end Every policy, plan, certificate, or contract referred to
in subdivision 1 that provides coverage to a Minnesota resident must provide coverage for
routine screening procedures for cancer and the office or facility visit, including
mammograms, surveillance tests for ovarian cancer for women who are at risk for ovarian
cancer as defined in subdivision 3, pap smears, and colorectal screening tests for men and
women, when ordered or provided by a physician in accordance with the standard practice
of medicine.

new text begin (b) Every policy, plan, certificate, or contract referred to in subdivision 1 that provides
coverage to a Minnesota resident must provide coverage for all diagnostic and preventive
screenings and tests related to breast cancer, including but not limited to genetic testing,
breast examination, mammography, magnetic resonance imaging, digital breast
tomosynthesis, ultrasound, thermography, biopsy, and other breast cancer screening tests
currently being evaluated by the federal Food and Drug Breast Cancer Research Foundation.
new text end

new text begin (c) A health carrier is prohibited from placing age limitations or annual or lifetime testing
limitations on the screenings and tests described in paragraph (b).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, and applies to health
plans offered, issued, or renewed on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2020, section 62A.30, subdivision 4, is amended to read:

Subd. 4.

Mammograms.

(a) For purposes of subdivision 2, new text begin paragraph (a), new text end coverage for
a preventive mammogram screening (1) includes digital breast tomosynthesis deleted text begin for enrollees
at risk for breast cancer deleted text end , and (2) is covered as a preventive item or service, as described
under section 62Q.46.

(b) For purposes of this subdivision, "digital breast tomosynthesis" means a radiologic
procedure that involves the acquisition of projection images over the stationary breast to
produce cross-sectional digital three-dimensional images of the breast. deleted text begin "At risk for breast
cancer" means:
deleted text end

deleted text begin (1) having a family history with one or more first- or second-degree relatives with breast
cancer;
deleted text end

deleted text begin (2) testing positive for BRCA1 or BRCA2 mutations;
deleted text end

deleted text begin (3) having heterogeneously dense breasts or extremely dense breasts based on the Breast
Imaging Reporting and Data System established by the American College of Radiology; or
deleted text end

deleted text begin (4) having a previous diagnosis of breast cancer.
deleted text end

deleted text begin (c) This subdivision does not apply to coverage provided through a public health care
program under chapter 256B or 256L.
deleted text end

deleted text begin (d) Nothing in this subdivision limits the coverage of digital breast tomosynthesis in a
policy, plan, certificate, or contract referred to in subdivision 1 that is in effect prior to
January 1, 2020.
deleted text end

deleted text begin (e) Nothing in this subdivision prohibits a policy, plan, certificate, or contract referred
to in subdivision 1 from covering digital breast tomosynthesis for an enrollee who is not at
risk for breast cancer.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022, and applies to health
plans offered, issued, or renewed on or after that date.
new text end

Sec. 3.

Minnesota Statutes 2020, section 256B.0625, subdivision 14, is amended to read:

Subd. 14.

Diagnostic, screening, and preventive services.

(a) Medical assistance covers
diagnostic, screening, and preventive services.

(b) "Preventive services" include services related to pregnancy, including:

(1) services for those conditions which may complicate a pregnancy and which may be
available to a pregnant woman determined to be at risk of poor pregnancy outcome;

(2) prenatal HIV risk assessment, education, counseling, and testing; and

(3) alcohol abuse assessment, education, and counseling on the effects of alcohol usage
while pregnant. Preventive services available to a woman at risk of poor pregnancy outcome
may differ in an amount, duration, or scope from those available to other individuals eligible
for medical assistance.

(c) "Screening services" include, but are not limited to, blood lead tests.

new text begin (d) Coverage of diagnostic screenings and tests under this subdivision must comply with
section 62A.30.
new text end

deleted text begin (d) deleted text end new text begin (e) new text end The commissioner shall encourage, at the time of the child and teen checkup or
at an episodic care visit, the primary care health care provider to perform primary caries
preventive services. Primary caries preventive services include, at a minimum:

(1) a general visual examination of the child's mouth without using probes or other dental
equipment or taking radiographs;

(2) a risk assessment using the factors established by the American Academies of
Pediatrics and Pediatric Dentistry; and

(3) the application of a fluoride varnish beginning at age one to those children assessed
by the provider as being high risk in accordance with best practices as defined by the
Department of Human Services. The provider must obtain parental or legal guardian consent
before a fluoride varnish is applied to a minor child's teeth.

At each checkup, if primary caries preventive services are provided, the provider must
provide to the child's parent or legal guardian: information on caries etiology and prevention;
and information on the importance of finding a dental home for their child by the age of
one. The provider must also advise the parent or legal guardian to contact the child's managed
care plan or the Department of Human Services in order to secure a dental appointment
with a dentist. The provider must indicate in the child's medical record that the parent or
legal guardian was provided with this information and document any primary caries
prevention services provided to the child.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2022.
new text end