03/27/2008
Colorectal cancer screening mandate to be implemented for July 2008
As a result of a recent mandate, we are making changes that affect our group health plans effective July 1, 2008, to comply with the new law as follows:
Colorectal cancer screening (applies to groups as they enroll or renew effective July 2008)
The colorectal cancer screening mandate requires health plans to provide coverage or benefits for colorectal cancer screening exams and lab tests consistent with U.S. Preventive Services Task Force or CDC guidelines. Colorectal cancer screening tests include fecal occult blood test (FOBT), flexible sigmoidoscopies, combination FOBT and flexible sigmoidoscopies, colonoscopies, and double-contrast barium enemas.
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Group Plan Type
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Group Contract Changes
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Preferred Plans
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- Cover colorectal services—including colonoscopies, sigmoidoscopies, FOBTs and barium enemas billed with a preventive diagnosis—the same as any other preventive condition, not subject to the deductible or to any preventive care benefit dollar limit.
- If the preventive care benefit is excluded, routine colorectal services will be covered at medical levels.
- Plans with the unlimited preventive care benefit are currently in compliance.
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AdvanceSM
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- Colorectal services billed as preventive will be covered at 100% for PPO and 50% for non-PPO, not subject to the deductible or to any preventive care benefit limit or upfront X-ray and lab benefit.
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Asuris HSA Healthplan
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EmbarkSM and VantageSM
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Large, negotiated group health plans must comply with the mandate.
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Read more about this mandate.
In order to keep your clients informed about this change, we are providing groups with this information in their Summary of Change letter beginning with July 2008 effective dates.
Our May 2008 issue of Agent News will describe the impact that state mandates—including colorectal cancer screening and dependent age—will have on our Individual plans.
If you have questions, please talk to your Asuris Sales contact.
Note: To print a PDF document, you need Adobe® Acrobat® Reader. Download it now for free.
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