Bill
S 776
Requires no-cost colorectal cancer screening starting at age 30 for insured Massachusetts residents, with defined tests and frequencies.
Status: Introduced 1/16/2025 (Sen. Edward J. Kennedy). Bill later SUBSTITUTED BY A1476. Referred to committee (Financial/Finance). Hearing scheduled 09/17/2025 (Gardner Auditorium).
Purpose
- Require broad, no-cost coverage for colorectal (colon) cancer screening beginning at age 30 for people insured under a wide range of Massachusetts public and private health plans. The stated intent is to remove financial barriers to earlier and more frequent screening.
Key provisions
- Coverage mandate: Requires coverage, beginning at age 30, for colorectal cancer screening whenever the insured’s primary care physician deems it medically necessary.
- Covered screening modalities and frequencies specified:
- Flexible sigmoidoscopy every 5 years; or every 10 years plus annual FIT
- KRAS, BRAF, PIK3CA array — “as frequent as medically necessary”
- FIT‑DNA (stool DNA) every year or every 3 years, as medically necessary
- FIT (fecal immunochemical test) annually
- HSgFOBT annually
- CT colonography every 5 years
- Colonoscopy every 5 or 10 years
- Defines “colonoscopy” to include visual examination of the entire colon and concurrent polypectomy and/or biopsy.
- No cost-sharing: Screening services covered under the mandate shall not be subject to co‑payments, deductibles, coinsurance, or other cost-sharing. Insureds also shall not face additional charges for services associated with screening (examples listed: tissue removal, laboratory services, physician services, facility use, anesthesia).
- Scope / statutes amended: Adds parallel sections to multiple Massachusetts statutes to require coverage across:
- Chapter 32A (Group Insurance Commission — state employees/retirees)
- Chapter 118E (MassHealth / Medicaid managed care)
- Chapter 175 (accident & sickness insurance)
- Chapter 176A (hospital service plans / HMOs)
- Includes contractual entities (contracted insurers, HMOs, third‑party administrators, behavioral health firms under contract with Medicaid MCOs).
Who is affected
- All persons age 30 and older insured under:
- State Group Insurance Commission plans (active/retired state employees)
- MassHealth managed care and related contracts
- Commercial accident & sickness insurance policies and group blanket policies
- Individual and group hospital service plans and HMOs issued/renewed in Massachusetts
- Health care providers who deliver colorectal screening and related services
- Public payers and private insurers, which must absorb coverage and eliminate cost-sharing for these services
Procedural / timeline notes
- Filed in the Massachusetts Senate on 1/16/2025 by Sen. Edward J. Kennedy (First Middlesex).
- Read twice and referred to Committee on Financial/Finance (2/27/2025). Listed as SUBSTITUTED BY A1476 (2/05/2025). Hearing scheduled for 09/17/2025.
- Current active legislative vehicle appears to be companion/substitute bill A1476; readers should consult that bill’s text and status for the ongoing legislative path.
Potential impacts (expected)
- Clinical: Lowering the guaranteed covered screening age to 30 could increase early detection of colorectal cancer and precancerous lesions in younger adults.
- Financial: Insurers and state programs would incur higher near‑term costs from increased screening utilization but may realize long‑term savings from earlier diagnosis and reduced advanced‑stage treatment costs. Exact fiscal impact would depend on utilization rates, reimbursement, and behavioral response.
- Access: Eliminating cost-sharing for both screening and related services reduces out‑of‑pocket barriers and may improve screening uptake, especially among lower‑income populations.
Notes / caveats
- The bill prescribes specific screening frequencies and modalities but ties use to the primary care physician’s medical necessity determination.
- For final operative language and fiscal analyses, review the substitute companion bill A1476 and any committee reports or amendments.
Compiled from official sources — confirm details with the bill’s official record.
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