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PA Bulletin, Doc. No. 98-935



Mandated Benefits

[28 Pa.B. 2739]

   Section 9 of Act 34 of 1993 requires that the Health Care Cost Containment Council (Council) review existing or proposed mandated health benefits on request of the executive and legislative branches of government. The Council has been requested by Senator F. Joseph Loeper, Chairperson of the Senate Rules Committee, to review Senate Bill 39, the proposed Cancer Prevention and Early Detection Services Act which would require insurance coverage of certain cancer-related services, as well as a proposed amendment that would exclude the following from affected health insurance policies: ''accident only, fixed indemnity, limited benefit, credit, dental, vision, specified disease, Medicare supplement, Civilian Health and Medical Program of the Uniform Service (CHAMPUS) supplement, long-term care or disability income, workers' compensation or automobile medical payment insurance.'' The amendment would also add coverage of annual digital rectal exams and prostate specific antigen tests for men 40-years old and older with certain prostate cancer risk factors and would specify that the benefits be subject to the same copayment and coinsurance provisions of an insurance policy as other medical services, but shall be exempt from any deductible or dollar limit provisions.

   Initial notification of request for information and documentation was published in the Pennsylvania Bulletin on March 14, 1998, with documentation due to the Council by May 29, 1998.

   Following is a list of the documentation received. This information is available for public review and comment at the Council offices during regular business hours (8:30 a.m. to 5 p.m.) until July 7, 1998. Any additional comments on this information must be received by this time. Council offices are located at: 225 Market Street, Suite 400, Harrisburg, PA 17101. Send comments to Flossie Wolf at this address.

Senate Bill 39 Submissions

   1.  Highmark

   *   Letter from Bruce R. Hironimus, Vice President of Government Affairs, addressing Section 9 requirements

   *   Relevant research articles

   *   Cancer facts/incidence information

   2.  AFLAC (American Family Life Assurance Company of Columbus)

   *   Letter from Richard J. Gmerek and Elvira O. Guida of the Law Offices of Maley, Williamson, Hayden & Gmerek, addressing Section 9 requirements and supporting proposed amendment A0385 to SB 39 to exempt supplemental policies

   3.  The Insurance Federation of Pennsylvania, Inc.

   *   Letter from John R. Doubman, Secretary & Counsel, addressing Section 9 requirements

   *   Article from the Philadelphia Inquirer

   4.  American Cancer Society, Commonwealth Division, Inc.

   *   Letter from Francis X. O'Brien, Jr. of Buchanan Ingersoll, addressing Section 9 requirements

   *   Cancer fact/incidence information

   5.  Managed Care Association of Pennsylvania

   *   Letter from Kimberly J. Kockler, Executive Director, addressing Section 9 requirements and opposing implementation of SB 39

   *   Research articles

   6.  Fox Chase Cancer Center

   *   Letter from Deborah Watkins Bruner, RN, MSN, Program Director, addressing Section 9 requirements and supporting implementation of prostate cancer coverage proposed in SB 39

   *   Prostate cancer facts/ incidence information

   *   Research articles

   *   Copies of bills proposed in New Jersey and Maryland

   7.  American Foundation for Urologic Disease, Inc.

   *   Letter from M. Brooke Moran, Director of Patient Advocacy & Government Affairs, supporting implementation of prostate cancer coverage proposed in SB 39

   *   Comparison of costs for prostate cancer screening and breast cancer screening

   *   List of states mandating insurance coverage of prostate cancer coverage

   *   Copies of bills proposed in Maryland and New Jersey

   8.  Robert Alexander

   *   Letter supporting prostate cancer coverage proposed in SB 39

   *   Newspaper article

   *   Prostate cancer facts

Executive Director

[Pa.B. Doc. No. 98-935. Filed for public inspection June 12, 1998, 9:00 a.m.]

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