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REFERENCE TITLE: breast cancer gene; screening; coverage |
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State of Arizona House of Representatives Fifty-fifth Legislature Second Regular Session 2022
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HB 2529 |
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Introduced by Representatives Schwiebert: Andrade, Blackwater-Nygren, Bolding, Butler, Cano, Fernandez B, Jermaine, Liguori, Powers Hannley, Solorio, Senators Gonzales, Stahl Hamilton
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AN ACT
amending title 20, chapter 4, article 3, arizona revised statutes, by adding section 20-841.13; amending title 20, chapter 4, article 9, arizona revised statutes, by adding section 20-1057.19; amending title 20, chapter 6, article 4, arizona revised statutes, by adding section 20-1376.10; amending title 20, chapter 6, article 5, arizona revised statutes, by adding section 20-1406.10; amending Title 32, chapter 32, article 1, Arizona Revised Statutes, by adding section 32-3230; Amending Title 36, chapter 29, article 1, Arizona Revised Statutes, by adding section 36-2907.16; relating to health care coverage.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 20, chapter 4, article 3, Arizona Revised Statutes, is amended by adding section 20-841.13, to read:
20-841.13. Breast cancer gene; coverage; definitions
A. A hospital service corporation or medical service corporation that issues, delivers or renews a subscription contract in this state on or after January 1, 2023 shall provide coverage for screening, genetic counseling and testing for harmful mutations in the BRCA gene for subscribers under circumstances where the screening, genetic counseling or testing is necessary.
B. A hospital service corporation or medical service corporation shall ensure that the benefits required by this section are made available to a subscriber through a health care provider who is a member of the provider network of the hospital service corporation or medical service CORPORATION.
C. for the purposes of this section:
1. "BRCA gene" means the breast cancer gene.
2. "Health care provider" means a person who is certified or licensed pursuant to title 32, chapter 13, 15, 17, 25 or 29.
Sec. 2. Title 20, chapter 4, article 9, Arizona Revised Statutes, is amended by adding section 20-1057.19, to read:
20-1057.19. Breast cancer gene; coverage; definitions
A. A health care services organization that issues, delivers or renews an evidence of coverage in this state on or after January 1, 2023 shall provide coverage for screening, genetic counseling and testing for harmful mutations in the BRCA gene for enrollees under circumstances WHERE the screening, genetic counseling or testing is necessary.
B. A health care services organization shall ensure that the benefits required by this section are made available to an enrollee through a health care provider who participates in the network plan of the health care services organization.
c. For the purposes of this section:
1. "BRCA gene" means the breast cancer gene.
2. "Health care provider" means a person who is certified or licensed pursuant to title 32, chapter 13, 15, 17, 25 or 29.
Sec. 3. Title 20, chapter 6, article 4, Arizona Revised Statutes, is amended by adding section 20-1376.10, to read:
20-1376.10. Breast cancer gene; coverage; definitions
A. A disability insurer that issues, delivers or renews a policy in this state on or after January 1, 2023 shall provide coverage for screening, genetic counseling and testing for harmful mutations in the BRCA gene for insureds under circumstances WHERE the screening, genetic counseling or testing is necessary.
b. A disability insurer shall ensure that the benefits required by this section are made available to an insured through a health care provider who participates in the network plan of the disability insurer.
c. For the purposes of this section:
1. "BRCA gene" means the breast cancer gene.
2. "Health care provider" means a person who is certified or licensed pursuant to title 32, chapter 13, 15, 17, 25 or 29.
Sec. 4. Title 20, chapter 6, article 5, Arizona Revised Statutes, is amended by adding section 20-1406.10, to read:
20-1406.10. Breast cancer gene; coverage; definitions
A. A group or blanket disability insurer that issues, delivers or renews a contract in this state on or after January 1, 2023 shall provide coverage for screening, genetic counseling and testing for harmful mutations in the BRCA gene for subscribers under circumstances WHERE the screening, genetic counseling or testing is necessary.
B. A Group or blanket disability insurer shall ensure that the benefits required by this section are made available to a subscriber through a health care provider who participates in the network plan of the group or blanket disability insurer.
c. For the purposes of this section:
1. "BRCA gene" means the breast cancer gene.
2. "Health care provider" means a person who is certified or licensed pursuant to title 32, chapter 13, 15, 17, 25 or 29.
Sec. 5. Title 32, chapter 32, article 1, Arizona Revised Statutes, is amended by adding section 32-3230, to read:
32-3230. Primary care providers; breast cancer gene; screening; genetic counseling; testing; definitions
A. A primary care provider shall:
1. Attempt to determine whether each adult patient to whom the primary care provider provides care has a personal or family history of melanoma or breast, ovarian, tubal or peritoneal cancer, has an ancestry associated with a harmful mutation in the BRCA gene or meets any other criteria under which an independent nationwide panel of experts in primary care and prevention that systematically reviews and recommends clinical preventive services has recommended screening for a risk of such a mutation.
2. If the primary care provider determines that an adult patient to whom the primary care provider provides care meets the criteria described in paragraph 1 of this subsection and has not previously undergone genetic testing for a harmful mutation in the BRCA gene, use an appropriate brief familial risk assessment tool to screen for a risk of such a mutation.
B. If the screening performed pursuant to subsection A of this section indicates that a patient is at risk of a harmful mutation in the BRCA gene, the primary care provider shall do all of the following:
1. Provide the patient with written notice of the need to discuss genetic counseling and testing with the primary care provider.
2. Provide genetic counseling to the patient or refer the patient for genetic counseling.
3. If a genetic test for harmful mutations in the BRCA gene is clinically indicated as a result of the genetic counseling, administer a genetic test to the patient or refer the patient for genetic testing.
C. A primary care provider who fails to comply with this section is not subject to criminal penalties or professional discipline for the noncompliance.
D. For the purposes of this section:
1. "BRCA gene" means the breast cancer gene.
2. "Primary care provider" means a person who is certified or licensed pursuant to chapter 13, 15, 17, 25 or 29 of this title.
Sec. 6. Title 36, chapter 29, article 1, Arizona Revised Statutes, is amended by adding section 36-2907.16, to read:
36-2907.16. Breast cancer gene; screening, genetic counseling and testing
The administration and its contractors, to the extent authorized by federal law, shall provide screening, genetic counseling and testing for harmful mutations in the breast cancer gene for members when indicated pursuant to section 32-3230.