NOTE: As provided in LFC policy, this report is
intended only for use by the standing finance committees of the
legislature. The Legislative Finance Committee does not assume
responsibility for the accuracy of the information in this report when used for
other purposes.
The most recent FIR
version (in HTML & Adobe PDF formats) is available on the Legislative
Website. The Adobe PDF version includes
all attachments, whereas the HTML version does not. Previously issued FIRs and attachments may be
obtained from the LFC in
|
SPONSOR: |
Park |
DATE TYPED: |
|
HB |
HJM 74/aHBIC |
||
|
SHORT TITLE: |
Study Colorectal Cancer Insurance Coverage |
SB |
|
||||
|
|
ANALYST: |
|
|||||
APPROPRIATION
|
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
||
|
FY03 |
FY04 |
FY03 |
FY04 |
|
|
|
|
NFI
|
|
|
|
|
|
|
|
|
|
|
|
(Parenthesis
( ) Indicate Expenditure Decreases)
Responses
Received From
Department
of Health (DOH)
SUMMARY
The House Business and Industry Committee amends the bill by including the “insurance superintendent”
as a member of the Task Force.
Synopsis
of Original Bill
House Joint Memorial 74 requests that the
New Mexico Department of Health (DOH) create a task force to investigate the
issues concerning insurance coverage for, and access to, screening and early
detection for colorectal cancer. The task force would include representatives
from the American Cancer Society, NM Medical Society, health care
practitioners, health care providers and others. The Task Force is to report its findings and
recommendations to the appropriate interim committee by October 2003.
Significant
Issues
Colorectal cancer is the second leading cause of cancer death
in the state, following lung cancer.
Each year in
Screening and early detection for colorectal cancer can not
only diagnose cancers earlier, when they are more responsive to treatment, but
can even prevent the disease. Nationally, colorectal cancer incidence rates
went down 1.8% each year from 1985 – 1995.
Research suggests the decrease is due in part to increased screening and
the removal of pre-cancerous polyps (American Cancer Society, 2003).
Overall screening rates for colorectal cancer are low, with
only 32% of adult New Mexicans reporting ever having had a sigmoidoscopy or
colonoscopy. The national median is
33.7%. Screening rates are highest for
New Mexicans age 65 and older; however only 51% in this age group report ever
having had a sigmoidoscopy or colonoscopy (Centers for Disease Control and
Prevention, 2000).
Since HJM 74 is to address insurance coverage of screening
and early detection tests for colorectal cancer, it is recommended that the
Superintendent of Insurance within the Public Regulation Commission be asked to
participate in the Task Force.
FISCAL IMPLICATIONS
HJM 74 could be
accomplished within existing resources.
The DOH currently contracts with the New Mexico Medical
Society in the amount of $10,000, to coordinate the Colorectal Cancer Workgroup
of the Clinical Prevention Initiative (CPI).
The DOH and members of the CPI would collaborate to fulfill the
obligations stipulated in HJM 74.
ADMINISTRATIVE IMPLICATIONS
HJM
74 could be administered within existing resources.
OTHER SUBSTANTIVE ISSUES
Priority populations at risk for colorectal
cancer are all men and women over age 50, as well as those of any age who have
medical risk factors such as a family history of colorectal cancer. As the number of older New Mexicans
increases, so too will the number of people at risk for colorectal cancer. A total of 12,016 new cases and 5,487 deaths
from colorectal cancer were reported in New Mexicans between 1970 and 1996
(Office of Epidemiology, DOH & NM Tumor Registry, University of NM,
1998). Colorectal cancer is second only
to lung cancer for cancer deaths among all New Mexicans (American Cancer
Society, 2000).
Early detection has
been shown to be effective in reducing both the incidence and mortality of
colorectal cancer. For New Mexicans
diagnosed between 1973 and 1999, the five-year relative survival rate for
localized colorectal cancer was 76%, while the rate for regional stage (when
the cancer has spread beyond the colon/rectum) was 55%; for distant stage (when
the cancer has spread to other parts of the body) the survival rate dropped to
7% (New Mexico Tumor Registry, 2002).
Screening for
colorectal cancer includes fecal occult blood testing, double-contrast barium
enema, flexible sigmoidoscopy, and colonoscopy.
These methods can diagnose the disease in early, pre-symptomatic stages
when treatment is more likely to be effective.
In addition, screening with colonoscopy can prevent cancer by detecting
and removing pre-cancerous polyps.
In 1999, less than half of New Mexicans aged 50 and older
reported ever having a colorectal screening examination (American Cancer
Society, 2000). Two thirds of colorectal
cancers diagnosed in
Screening recommendations vary, although the age at which
screening begins is 50 for the general population. The US Preventive Services Task Force
(USPSTF) is an independent panel of primary health care and prevention experts
that reviews studies and develops recommendations for clinical preventive
services. In July 2002, the USPSTF
reported that studies show colorectal cancer screening is likely to
be cost effective, whichever screening method is used. The USPSTF recommends the screening strategy
decision be based on patient choice, medical needs, patient adherence, and the
availability of testing and follow-up resources.
Currently, Medicare pays for colorectal cancer screening for
eligible Americans at average risk. In
addition, Medicare pays for colonoscopy every two years for high-risk
individuals. Because Medicare primarily
serves those aged 65 and older, insurance coverage for colorectal cancer
screening would affect average-risk New Mexicans between the ages of 50 and 64,
and those at increased risk who need more frequent screening. Issues concerning access would affect all New
Mexicans seeking screening and early detection for colorectal cancer.
Page
2, line 10 after “
BD/prr:yr