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Archived File – for Reference Use.
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COMMISSIONER'S BULLETIN # B-0006-09

January 30, 2009


To: All insurers licensed to write life and accident and health insurance, group hospital service corporations, fraternal benefit societies, lloyd's plans, stipulated premium companies, health maintenance organizations, all multiple employer welfare agreements (mewas), and approved nonprofit health corporations licensed in texas and risk pools under local government code chapter 172


Re: Colorectal Cancer Screening Tests

The purpose of this bulletin is to make regulated entities aware that The American Cancer Society along with the US Multi Society Task Force on Colorectal Cancer, and the American College of Radiology has released joint consensus guidelines for colorectal cancer screening for average-risk adults. The current guidelines were last updated in 2003. The new guidelines recommend that the stool DNA test and the Computed Tomography (CT) colonography (also known as virtual colonoscopy) are now acceptable forms of colon cancer screening for average-risk adults. The new guidelines are published in CA: A Cancer Journal for Clinicians, Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology, CA Cancer J Clin 2008 58: 130-160.

The Department alerts regulated entities of the new guidelines and reminds them that Texas Insurance Code §1363.003 requires a medically recognized screening examination for the detection of colorectal cancer in certain situations. A health benefit plan that provides coverage for screening medical procedures must also provide colorectal cancer detection coverage to individuals enrolled in the plan 50 years of age or older and at normal risk for developing colon cancer. The coverage must include expenses incurred in conducting a medically recognized screening examination for the detection of colorectal cancer.

If you have any questions or concerns in determining compliance with state and federal law in this area, please contact a member of the Accident and Health Section at 512/322-3409 or the HMO Compliance Section at 512/322-4266.



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Last updated: 09/07/2014

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