Health insurance coverage requirements clarified by new bill in House

by Andrew Stein, VTdigger.org - A bill is moving quickly through the Vermont House that clarifies a requirement that health insurers cover the total cost of mammograms, colonoscopies and additional exams associated with these cancer tests.
Representative George Till, D-Jericho, who introduced H.136, said that a 2007 law pertaining to coverage of colonoscopies and a 2009 law regarding coverage of mammograms should already provide full coverage for these preventive services. But the existing laws aren’ t always effective.
‘ It’ s already in the statute,’ Till said. ‘ It’ s just we’ ve had a lot of people go in and get an unexpected bill. There’ s clearly a problem, but it’ s not clear how much of the problem is with insurers and how much of it is a problem with hospitals and providers.’
The bill would clarify existing statutes under Title 8. And in a state that has a breast cancer rate above the national average, the only physician in the House of Representatives said it’ s very important that Vermonters are screened on schedule for breast and colon cancer.
‘ If people think it’ s going to cost them a significant amount of money, they won’ t get them,’ he said. ‘ It’ s a matter of making sure people have access to the testing they ought to be having.’
Susan Gretkowski, a lobbyist for MVP Health Care, said the insurance company would not experience a change as a result of the clarification. She said the problem was with how some providers were interpreting the law. The new provision won’ t affect MVP ratepayers, she said.
‘ Since we’ re already doing this, there will be no impacts on rates,’ she said. ‘ Right now, we already cover the types of things that would be required in the bill, so if it’ s a screening mammography and they need an extra film, we would cover that with no additional patient out-of-pocket.’
The House unanimously voted to move H.136 forward March 19, and the bill headed for a third and final reading on the House floor March 20.