SENATE BUDGET AND APPROPRIATIONS COMMITTEE

STATEMENT TO

SENATE, No. 2305

STATE OF NEW JERSEY

DATED:  OCTOBER 13, 2022

      The Senate Budget and Appropriations Committee reports favorably Senate Bill No. 2305.

This bill requires health insurance coverage of colorectal cancer screenings recommended by the United States Preventive Services Task Force (USPSTF) and eliminates cost-sharing requirements for colonoscopies performed following a positive result on a non-colonoscopy, colorectal cancer screening test.

     Presently, health benefit plans are only required to cover a colorectal cancer screening at regular intervals for a person who is aged 50 and over, or for a person of any age who is considered to be at high risk for colorectal cancer. 

     Under this bill, health insurance carriers (including health service corporations, hospital service corporations, medical service corporations, health maintenance organizations authorized to issue health benefits plans in New Jersey, entities contracted to administer health benefits in connection with the State Health Benefits Program or School Employees’ Health Benefits Program, and the Medicaid Program) will be required to cover a colorectal cancer screening recommended by the USPSTF.  The bill also eliminates cost-sharing requirements for colonoscopies performed following a positive result on a non-colonoscopy, colorectal cancer screening test recommended by the USPSTF.

FISCAL IMPACT:

      The Office of Legislative Services (OLS) estimates that this bill will have no material impact on the State Health Benefits Program or the School Employees’ Health Benefits Program to eliminate cost sharing for coverage for certain colorectal cancer screenings for individuals who are 45 years of age and older, in accordance with the United State Preventive Services Task Force recommendations.  This is because these services are already being provided, for the most part, without any cost sharing requirements in accordance with the federal Affordable Care Act.  However, in some cases, individuals have been charged for prescriptions related to the procedure and for a portion of the procedure if the procedure is changed from preventive to diagnostic after the fact.

      According to the Plan Year 2023 Rate Renewal reports for the State Health Benefits Program and School Employees’ Health Benefits Program, “Effective March 1, 2022, the recommended age for select preventive cancer screening is being lowered.  This may increase utilization of preventive care but is deemed to have no significant impact on cost in this analysis."

      Similarly, the OLS surmises that there would be no material fiscal impact on the State Health Benefits Plan and the School Employees’ Health Benefits Plan if cost sharing for colonoscopies performed following a positive result on a non-colonoscopy, colorectal cancer screening test that is recommended by the United States Preventive Services Task Force were eliminated.

      The OLS finds that the bill’s provisions will have no impact on the Medicaid program.  As of January 1, 2013, per Section 4106 of the federal Affordable Care Act, states can receive a one percentage point increase in their federal Medicaid match rate for preventive services, including colorectal cancer screenings, if they cover without cost sharing all the adult preventive services.  As such, since April 1, 2013, the New Jersey Medicaid program has covered colorectal cancer screenings, without cost-sharing, according to the recommendations of the United States Preventive Services Task Force.