Chapter 405

2005 -- H 5999 SUBSTITUTE A AS AMENDED

Enacted 07/19/05

 

A N A C T

RELATING TO ACCIDENT AND SICKNESS INSURANCE POLICIES

 

     Introduced By: Representatives Gemma, Faria, Winfield, Sullivan, and Gallison

     Date Introduced: March 01, 2005

 

It is enacted by the General Assembly as follows:

 

      SECTION 1. Section 27-18-41 of the General Laws in Chapter 27-18 entitled "Accident

and Sickness Insurance Policies" is hereby amended to read as follows:

 

     27-18-41. Mammograms and pap smears -- Coverage mandated. -- (a)(1) Every

individual or group hospital or medical expense insurance policy or individual or group hospital

or medical services plan contract delivered, issued for delivery, or renewed in this state shall

provide coverage for mammograms and pap smears, in accordance with guidelines established by

the American Cancer Society.

     (2) Notwithstanding the provisions of this chapter, every individual or group hospital or

medical insurance policy or individual or group hospital or medical services plan contract

delivered, issued for delivery, or renewed in this state shall provide coverage for two (2)

screening mammograms per year when recommended by a physician for women who have been

treated for breast cancer within the last five (5) years or are at high risk of developing breast

cancer due to genetic predisposition (BRCA gene mutation or multiple first degree relatives) or

high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical ductal hyperplasia.

      (b) This section shall not apply to insurance coverage providing benefits for: (1) hospital

confinement indemnity; (2) disability income; (3) accident only; (4) long term care; (5) Medicare

supplement; (6) limited benefit health; (7) specified disease indemnity; (8) sickness or bodily

injury or death by accident or both; and (9) other limited benefit policies.

 

     SECTION 2. Section 27-19-20 of the General Laws in Chapter 27-19 entitled "Nonprofit

Hospital Service Corporations" is hereby amended to read as follows:

 

     27-19-20. Mammograms and pap smears -- Coverage mandated. – (a) Subscribers to

any nonprofit hospital service plan shall be afforded coverage under the plan for mammograms

and pap smears, in accordance with guidelines established by the American Cancer Society.

     (b) Notwithstanding the provisions of this chapter, subscribers to any nonprofit hospital

service plan shall be afforded coverage for two (2) screening mammograms per year when

recommended by a physician for women who have been treated for breast cancer within the last

five (5) years or are at high risk of developing breast cancer due to genetic predisposition (BRCA

gene mutation or multiple first degree relatives) or high risk lesion on prior biopsy (lobular

carcinoma in situ) or atypical ductal hyperplasia.

 

     SECTION 3. Section 27-20-17 of the General Laws in Chapter 27-20 entitled "Nonprofit

Medical Service Corporations" is hereby amended to read as follows:

 

     27-20-17. Mammograms and pap smears -- Coverage mandated. – (a) Subscribers to

any nonprofit medical service plan shall be afforded coverage under the plan for mammograms

and pap smears, in accordance with guidelines established by the American Cancer Society.

     (b) Notwithstanding the provisions of this chapter, subscribers to any nonprofit medical

service plan shall be afforded coverage for two (2) screening mammograms per year when

recommended by a physician for women who have been treated for breast cancer within the last

five (5) years or are at high risk of developing breast cancer due to genetic predisposition (BRCA

gene mutation or multiple first degree relatives) or high risk lesion on prior biopsy (lobular

carcinoma in situ) or atypical ductal hyperplasia.

 

     SECTION 4. Section 27-41-30 of the General Laws in Chapter 27-41 entitled "Health

Maintenance Organizations" is hereby amended to read as follows:

 

     27-41-30. Mammograms and pap smears -- Coverage mandated. – (a) Subscribers to

any health maintenance organization plan shall be afforded coverage under that plan for

mammograms and pap smears, in accordance with guidelines established by the American Cancer

Society.

     (b) Notwithstanding the provisions of this chapter, subscribers to any health maintenance organization

shall be afforded coverage for two (2) paid screening mammograms per year when recommended by

a physician for women who have been treated for breast cancer within the last five (5) years or who are

at high risk of developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple first degree

relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical ductal hyperplasia.

 

     SECTION 5. This act shall take effect upon passage.     

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LC02418/SUB A/2

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