SENATE BILL REPORT

                   SB 6240

              As Reported By Senate Committee On:

           Health & Long-Term Care, January 31, 1996

Title:  An act relating to osteoporosis health services coverage.

Brief Description:  Providing for osteoporosis health services coverage.

Sponsors:  Senators Wojahn, Winsley, Thibaudeau, Loveland, Kohl, Long, Fairley, Wood, Prentice, McAuliffe, Sheldon, Roach, Rinehart, Hale, Spanel, Franklin, Drew, Snyder, Rasmussen, Fraser and Bauer.

Brief History:

Committee Activity:  Health & Long-Term Care:  1/23/96, 1/31/96 [DP, DNP].

SENATE COMMITTEE ON HEALTH & LONG-TERM CARE

Majority Report:  Do pass.

  Signed by Senators Quigley, Chair; Wojahn, Vice Chair; Fairley, Franklin, Thibaudeau, Winsley and Wood.

Minority Report:  Do not pass.

  Signed by Senator Moyer.

Staff:  Wendy Saunders (786-7439)

Background:  Osteoporosis is a devastating disease, which causes a thinning of the bones and often leads to severe fractures. These fractures cause pain, disability, immobility and threaten the independence of the twenty-five million Americans that suffer from the disease.

Osteoporosis effects approximately 50 percent of women and 20 percent of men. The direct and indirect costs of osteoporosis in the United States was $18 billion in 1993, and is expected to rise to $60-80 billion by 2020.

Osteoporosis commonly progresses without symptoms and remains undiagnosed until it has advanced to the point that the patient suffers fracture, typically of the hip, spine or wrist. 

Since there is no cure for osteoporosis, prevention, treatment and early detection are critical for reducing prevalence.

There are several screening methods currently available to detect osteoporosis, and treatment regimes that can mitigate the effects of osteoporosis.

Concern exists that the existing screening and treatment methods are not being used adequately because many health insurers do not provide benefits for them.  It has been suggested that screening and treatment are cost effective because they result in a decrease in fractures and disability, which corresponds to significant savings in associated health care costs.

Summary of Bill:  All insurers that provide hospital, medical or surgical coverage are required to cover osteoporosis prevention, diagnosis and treatment services.  They are also required to use current education materials to increase patient awareness and encourage prevention of osteoporosis.

Appropriation:  None.

Fiscal Note:  Requested on January 5, 1996.

Effective Date:  Ninety days after adjournment of session in which bill is passed.

Testimony For:  There is no cure for osteoporosis, which effect 50 percent of women and 20 percent of men.  The bill will reduce the costs associated with fractures from osteoporosis through early detection and treatment.

Testimony Against:  The bill fixes medical policy into law.  The screening and treatment services required to be covered under the bill should only be provided when medically necessary.  The cost sharing required in health care policies should be applicable to the services required in the bill.

Testified:  Pro: Dr. Mark Leighton, physician; Con: Scott Denies, Pierce County Medical; Ken Bertrand, Group Health.