CCS/HS/SCS/SB 1026 - This act modifies provisions relating to insurance coverage for cancer treatment and other inherited diseases.

Current law outlines procedures for making an anatomical donation. This act allows minors age sixteen or older to make an anatomical donation with parental consent. The consent must be noted on the minor's donor card, application, driver's license, or other gift document. Brackets are removed from the family member objection language in 194.220.2 and 194.220.3. This provision has an effective date of July 1, 2003 (Section 1). This provision is identical to SB 871 (Sections 194.220 and 194.230).

A new section requires health insurance companies to provide coverage for routine patient care costs incurred as the result of phase III or IV of clinical trials undertaken to treat cancer. Entities providing clinical trial treatment must have sufficient expertise and training to treat a sufficient number of patients. There must be identical or superior non-investigational treatment alternatives available before providing clinical trial treatment. Clinical trial coverage shall include coverage for drugs and devices approved by the FDA, whether or not the FDA has approved the drug or device for the patient's particular condition. The clinical trials will only be covered if they are approved or funded by certain entities. Providers participating in clinical trials shall obtain the patient's informed consent for participating in the clinical trial. This provision is similar to SB 827 (Section 376.429).

Current law mandates health insurance coverage for formula used in the treatment of phenylketonuria. This act also requires coverage for low protein modified food products intended for the treatment of inherited metabolic diseases. This provision is similar to HB 1695 (Section 376.1219).

A new section allows a physician to refer a patient who has been newly diagnosed with cancer to a specialist for a second opinion regarding the patient's treatment. Insurance companies must provide coverage for the second opinion rendered by the specialist. A referral must be given to an out of network specialist if a specialist is not available within the provider's network. This provision does not apply to certain insurance policies (Section 376.1253).

A new section requires certain health carriers and benefit plans to cover human leukocyte antigen testing for use in bone marrow transplantation. Testing must be performed in an appropriate facility. A form indicating informed consent must be completed which will authorize use of the results in the National Marrow Donor Program. Health plans may limit enrollees to one testing per lifetime to be reimbursed at a cost of no more than $75, but may not charge extra fees for the test. This provision is similar to SB 871 (Section 376.1275).
ERIN MOTLEY