HB 530 -- HEALTH INSURANCE

CO-SPONSORS:  Schaaf, Harris (23), Jones, Fraser, Meiners,
Campbell, Hilgemann, Yaeger, Hoskins, Bruns, Engler

COMMITTEE ACTION:  Voted "do pass" by the Committee on Health
Care Policy by a vote of 12 to 1.

This bill requires health insurers to cover phase I and phase II
of clinical trials for cancer treatment.  Current law requires
coverage only for phase III and IV of these trials.  The bill
clarifies that this mandate of coverage does not apply to
supplemental insurance policies.

FISCAL NOTE:  Estimated Net Cost to General Revenue Fund of
Unknown expected to exceed $70,000 in FY 2004, FY 2005, and FY
2006.  Estimated Net Income to Insurance Dedicated Fund of $8,000
in FY 2004, $0 in FY 2005, and $0 in FY 2006.  Estimated Net Cost
to Patrol Highway Fund of Unknown in FY 2004, FY 2005, and FY
2006.  Estimated Net Cost to Other State Funds of Unknown
expected to exceed $11,500 in FY 2004, FY 2005, and FY 2006.

PROPONENTS:  Supporters say that many cancer patients do not
participate in clinical cancer trials for various reasons,
including the costs resulting from treatments and the potential
denial of health insurance claims which have been submitted for
payment.  Patients in Missouri have consistently experienced
difficulty in obtaining insurance coverage for routine patient
costs incurred as a result of participating in phase I and phase
II clinical cancer trials.  The bill will provide increased
access to clinical cancer trials and treatments for cancer
patients.

Testifying for the bill were Representative Schaaf; Siteman
Cancer Center; Missouri Nurses Association; Jeff M. Michalski,
M.D.; University of Missouri Health Care; and Elizabeth
Grubesich.  Written letters of support were submitted by St.
Louis Ovarian Cancer Awareness; and Washington University School
of Medicine.

OPPONENTS:  Those who oppose the bill say that legislation was
passed in 2002 which requires insurance companies to provide
coverage for routine patient costs incurred by cancer patients
who participate in phase III and phase IV clinical cancer trials.
Due to the recent passage of the legislation, health insurers
have not been able to collect enough health insurance data in
order to determine the effectiveness and the feasibility of the
mandated insurance coverage.  Health insurers should not be
required to provide coverage for phase I and phase II clinical
cancer trials without the collection, analysis, and evaluation of
health insurance data concerning insurance coverage for phase I
and phase II clinical cancer trials.

Testifying against the bill were Blue Cross Blue Shield of
Missouri; Group Health Plan; and Coventry Healthcare Plan.

Joseph Deering, Legislative Analyst

Missouri House of Representatives
Last Updated July 25, 2003 at 10:12 am