SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness Insurance Policies" is hereby amended by adding thereto the following section: 27-18-96. Insurance coverage for lung cancer screening.
(a) The Rhode Island general assembly recognizes that lung cancer remains the leading cause of cancer deaths in Rhode Island and further that early detection of lung cancer will ensure that patients get the critical care they need without delay. Accordingly, it is in the best interests of the people of the state to promote widespread availability by eliminating out-of-pocket costs for lung cancer screenings.
(b) Every individual or group health insurance contract, plan, or policy that provides coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for follow-up screening or diagnostic services for lung cancer upon the recommendation of a health care provider acting within the provider's scope of practice, and as recommended by nationally recognized clinical practice guidelines for the detection of lung cancer. There shall be no copayment required, and no deductible shall need to be met for follow-up screening or diagnostic services for lung cancer. A deductible may be applied to health plans that are paired with a federally qualified health savings account pursuant to 26 U.S.C. § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
(c) For the purposes of this section, "nationally recognized clinical practice guidelines" means evidence-based, peer reviewed clinical practice guidelines informed by a systematic review of evidence and an assessment of the benefits, and risks of alternative care options intended to optimize patient care developed by independent organization professional societies utilizing a transparent methodology and reporting structure and with a conflict-of-interest policy.
(d) Nothing in this section shall be construed to prevent medical management or utilization review of the services, including preauthorization, to ensure that such services are consistent with nationally recognized clinical practice guidelines for the detection of lung cancer.
SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service Corporations" is hereby amended by adding thereto the following section: 27-19-88. Insurance coverage for lung cancer screening.
(a) The Rhode Island general assembly recognizes that lung cancer remains the leading cause of cancer deaths in Rhode Island and further that early detection of lung cancer will ensure that patients get the critical care they need without delay. Accordingly, it is in the best interests of the people of the state to promote widespread availability by eliminating out-of-pocket costs for lung cancer screenings.
(b) Every individual or group health insurance contract, plan, or policy that provides coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for follow-up screening or diagnostic services for lung cancer upon the recommendation of a health care provider acting within the provider's scope of practice, and as recommended by nationally recognized clinical practice guidelines for the detection of lung cancer. There shall be no copayment required, and no deductible shall need to be met for follow-up screening or diagnostic services for lung cancer. A deductible may be applied to health plans that are paired with a federally qualified health savings account pursuant to 26 U.S.C. § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
(c) For the purposes of this section, "nationally recognized clinical practice guidelines" means evidence-based, peer reviewed clinical practice guidelines informed by a systematic review of evidence and an assessment of the benefits, and risks of alternative care options intended to optimize patient care developed by independent organization professional societies utilizing a transparent methodology and reporting structure and with a conflict-of-interest policy.
(d) Nothing in this section shall be construed to prevent medical management or utilization review of the services, including preauthorization, to ensure that such services are consistent with nationally recognized clinical practice guidelines for the detection of lung cancer.
SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service Corporations" is hereby amended by adding thereto the following section: 27-20-84. Insurance coverage for lung cancer screening.
(a) The Rhode Island general assembly recognizes that lung cancer remains the leading cause of cancer deaths in Rhode Island and further that early detection of lung cancer will ensure that patients get the critical care they need without delay. Accordingly, it is in the best interests of the people of the state to promote widespread availability by eliminating out-of-pocket costs for lung cancer screenings.
(b) Every individual or group health insurance contract, plan, or policy that provides coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for follow-up screening or diagnostic services for lung cancer upon the recommendation of a health care provider acting within the provider's scope of practice, and as recommended by nationally recognized clinical practice guidelines for the detection of lung cancer. There shall be no copayment required, and no deductible shall need to be met for follow-up screening or diagnostic services for lung cancer. A deductible may be applied to health plans that are paired with a federally qualified health savings account pursuant to 26 U.S.C. § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
(c) For the purposes of this section, "nationally recognized clinical practice guidelines" means evidence-based, peer reviewed clinical practice guidelines informed by a systematic review of evidence and an assessment of the benefits, and risks of alternative care options intended to optimize patient care developed by independent organization professional societies utilizing a transparent methodology and reporting structure and with a conflict-of-interest policy.
(d) Nothing in this section shall be construed to prevent medical management or utilization review of the services, including preauthorization, to ensure that such services are consistent with nationally recognized clinical practice guidelines for the detection of lung cancer.
SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section: 27-41-101. Insurance coverage for lung cancer screening.
(a) The Rhode Island general assembly recognizes that lung cancer remains the leading cause of cancer deaths in Rhode Island and further that early detection of lung cancer will ensure that patients get the critical care they need without delay. Accordingly, it is in the best interests of the people of the state to promote widespread availability by eliminating out-of-pocket costs for lung cancer screenings.
(b) Every individual or group health insurance contract, plan, or policy that provides coverage and that is delivered, issued for delivery, prescribed, or renewed in this state on or after January 1, 2027, shall provide coverage for follow-up screening or diagnostic services for lung cancer upon the recommendation of a health care provider acting within the provider's scope of practice, and as recommended by nationally recognized clinical practice guidelines for the detection of lung cancer. There shall be no copayment required, and no deductible shall need to be met for follow-up screening or diagnostic services for lung cancer. A deductible may be applied to health plans that are paired with a federally qualified health savings account pursuant to 26 U.S.C. § 223. Nothing in this section would prohibit a health plan from implementing this benefit prior to January 1, 2027.
(c) For the purposes of this section, "nationally recognized clinical practice guidelines" means evidence-based, peer reviewed clinical practice guidelines informed by a systematic review of evidence and an assessment of the benefits, and risks of alternative care options intended to optimize patient care developed by independent organization professional societies utilizing a transparent methodology and reporting structure and with a conflict-of-interest policy.
(d) Nothing in this section shall be construed to prevent medical management or utilization review of the services, including preauthorization, to ensure that such services are consistent with nationally recognized clinical practice guidelines for the detection of lung cancer.
SECTION 5. This act shall take effect upon passage.
