Washington State
House of Representatives
Office of Program Research
BILL
ANALYSIS
Health Care & Wellness Committee
HB 1626
Brief Description: Concerning coverage for colorectal screening tests under medical assistance programs.
Sponsors: Representatives Bronoske, Rude, Ryu, Griffey, Callan, Fosse, Senn, Macri, Pollet, Graham, Leavitt and Reed.
Brief Summary of Bill
  • Directs the Health Care Authority to require coverage under medical assistance programs for noninvasive preventive colorectal cancer screening tests that have a grade of either A or B from the United States Preventive Services Task Force and to require coverage for colonoscopies performed as a result of a positive test result.
Hearing Date: 2/8/23
Staff: Christopher Blake (786-7392).
Background:

The United States Preventive Services Task Force (USPSTF) is a 16-member panel of experts that receives administrative, research and technical support from the federal Agency for Healthcare Research and Quality.  The USPSTF makes recommendations on clinical preventive services on a graded scale.  Under the federal Affordable Care Act, Medicaid expansion plans must cover preventive care services given an A or B rating by the USPSTF and traditional Medicaid plans that elect to cover those services receive a 1 percent increase in their federal matching funds for those services.
 
There are two main types of colorectal cancer screening tests:  stool-based tests and direct visualization tests.  Stool-based tests may either identify blood in the stool or cancer biomarkers shed from the lining of the colon in the stool to detect cancer.  Direct visualization tests view the inside of the colon and the rectum through various methods, including colonoscopy, computerized tomography colonography, and flexible sigmoidoscopy.  The USPSTF gives both types of colorectal cancer screenings an "A" rating for adults aged 50 to 75 years and a "B" rating for adults aged 45 to 49 years.
Summary of Bill:

Beginning January 1, 2024, the Health Care Authority must require coverage under medical assistance programs for noninvasive preventive colorectal cancer screening tests that have a grade of either A or B from the United States Preventive Services Task Force and to require coverage for colonoscopies performed as a result of a positive test result.
Appropriation: None.
Fiscal Note: Requested on February 2, 2023.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.