RD24 - Mandated Coverage for Menorrhagia


Executive Summary:
The Senate Committee on Commerce and Labor referred Senate Bill 1265 to the Special Advisory Commission on Mandated Health Insurance Benefits (Advisory Commission) during the 2003 Session of the General Assembly. Senate Bill 1265 was introduced by Senator Yvonne B. Miller.

The Advisory Commission held a public hearing on July 9, 2003, in Richmond to receive public comments on Senate Bill 1265. In addition to the patron, Senator Miller, three speakers addressed the proposal. A representative from the United Virginia Chapter of the National Hemophilia Foundation spoke in favor of Senate Bill 1265. Representatives from the Virginia Association of Health Plans (VAHP) and the Health Insurance Association of America (HIAA) spoke in opposition to the bill.

In addition, written comments in support of the bill were provided by the United Virginia Chapter of the National Hemophilia Foundation (NHF). Written comments in opposition to Senate Bill 1265 were provided by the VAHP and the HIAA.

Senate Bill 1265 would add menorrhagia to the hemophilia and congenital bleeding disorders mandate that requires insurers to provide coverage for these bleeding disorders. The mandate is applicable to insurers proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; corporations providing subscription contracts; and HMOs providing health care plans.

The bill defines “menorrhagia” as menstrual blood loss greater than 80 milliliters per menstrual cycle. The bill also adds menorrhagia to the current requirement that benefits be provided for expenses incurred in connection with the treatment of routine bleeding episodes associated with hemophilia, and other congenital bleeding disorders. The benefits in the current section are to include coverage for the purchase of blood products and blood infusion equipment required for home treatment of routine bleeding episodes when the home treatment program is under the supervision of the state-approved hemophilia treatment center.

The Advisory Commission voted unanimously (9 – No, 0 – Yes) on August 13, 2003 to recommend that Senate Bill 1265 not be enacted. The Advisory Commission believes that based on the information presented, coverage for the cost of diagnostic tests and the treatment of menorrhagia is currently available, and a mandate is not necessary at this time.