§36-6060.8. Prostate cancer screening coverage.

327 words·~1 min read·/ok/title-36-insurance/36-6060-8·

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

A. Any health benefit plan that is offered, issued or renewed in this state on or after January 1, 2000, that provides coverage to men forty

(40)years of age or older in this state shall offer coverage for annual screening for the early detection of prostate cancer in men over the age of fifty

(50)years and in men over the

age of forty

(40)years who are in high-risk categories. The coverage shall not be subject to policy deductibles. The coverage shall not exceed the actual cost of the prostate cancer screening up to a maximum of Sixty-five Dollars ($65.00) per screening.

B. The benefit required to be provided by subsection A of this section shall in no way diminish or limit diagnostic benefits otherwise allowable under a health benefit plan.

C. The prostate cancer screening coverage shall be offered as follows:

1. The screening shall be performed by a qualified medical professional including, but not limited to, a urologist, internist, general practitioner, doctor of osteopathy, nurse practitioner, or physician assistant;

2. The screening shall consist, at a minimum, of the following tests:

a. a prostate-specific antigen blood test, and

b. a digital rectal examination;

3. At least one screening per year shall be covered for any man fifty

(50)years of age or older; and

4. At least one screening per year shall be covered for any man from forty

(40)to fifty

(50)years of age who is at increased risk of developing prostate cancer as determined by a physician.

D. As used in this section, “health benefit plan” means any plan or arrangement as defined in subsection C of Section 6060.4 of this title. Added by Laws 1999, c. 137, § 1, eff. Nov. 1, 1999. Amended by Laws 2003, c. 464, § 8, eff. July 1, 2003; Laws 2010, c. 222, § 38, eff. Nov. 1, 2010. NOTE: Editorially renumbered from Title 36, § 6060.7 to avoid a duplication in numbering.