§ 4075.
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§ 4075. Craniofacial disorders
(a)(1) A health insurance plan shall provide coverage for diagnosis and medically necessary treatment, including surgical and nonsurgical procedures, for a musculoskeletal disorder that affects any bone or joint in the face, neck, or head and is the result of accident, trauma, congenital defect, developmental defect, or pathology. Subject to subsection
(b)of this section, this coverage shall be the same as that provided under the health insurance plan for any other musculoskeletal disorder in the body and shall be covered when the diagnosis or treatment, or both, is prescribed or administered by a physician or a dentist.
(2)This section shall not be construed to require coverage for dental services for the diagnosis or treatment of dental disorders or dental pathology primarily affecting the gums, teeth, or alveolar ridge.
(b)A health insurance plan may require a referral from a health care provider under contract with the plan. (Recodified and amended 2025, No. 11, § 2, eff. September 1, 2025.)