New Bulletin on Coverage for Colorectal Cancer Screening

On January 8, 2020, the Department of Financial Regulation published Insurance Bulletin #207, which relates to coverage for colorectal cancer (CRC) screening. Under Vermont law, insurers are required to provide coverage for CRC screening without any co-payment, deductible, coinsurance, or other cost-sharing requirements. Services associated with CRC screening include tissue removal, laboratory services, physician services, facility use, and anesthesia. For insureds over age 50, the benefit includes annual fecal occult blood testing plus one flexible sigmoidoscopy every five years, or one colonoscopy every 10 years.

In addition, for insureds who are at high risk of CRC, the benefit includes CRC screenings, exams, and laboratory tests as recommended by the treating physician. An individual is at high risk of CRC if they have a family history of CRC or genetic predisposition to CRC, a prior occurrence of CRC or precursor polyps, a prior occurrence of a chronic digestive disease, or other predisposing factors as determined by the treating physician.

The bulletin contains no new employer compliance obligations, but employers with fully insured plans in Vermont will want to be aware of the CRC services should employees have questions.

Insurance Bulletin #207 »