376.782. Mammography--low-dose screening, defined--health care policies to provide required coverage.
Mammography--low-dose screening, defined--health care policiesto provide required coverage.
376.782. 1. As used in this section, the term "low-dosemammography screening" means the X-ray examination of the breastusing equipment specifically designed and dedicated formammography, including the X-ray tube, filter, compressiondevice, films, and cassettes, with an average radiation exposuredelivery of less than one rad mid-breast, with two views for eachbreast, and any fee charged by a radiologist or other physicianfor reading, interpreting or diagnosing based on such X-ray.
2. All individual and group health insurance policiesproviding coverage on an expense-incurred basis, individual andgroup service or indemnity type contracts issued by a nonprofitcorporation, individual and group service contracts issued by ahealth maintenance organization, all self-insured grouparrangements to the extent not preempted by federal law and allmanaged health care delivery entities of any type or description,that are delivered, issued for delivery, continued or renewed onor after August 28, 1991, and providing coverage to any residentof this state shall provide benefits or coverage for low-dosemammography screening for any nonsymptomatic woman covered undersuch policy or contract which meets the minimum requirements ofthis section. Such benefits or coverage shall include at leastthe following:
(1) A baseline mammogram for women age thirty-five tothirty-nine, inclusive;
(2) A mammogram for women age forty to forty-nine,inclusive, every two years or more frequently based on therecommendation of the patient's physician;
(3) A mammogram every year for women age fifty and over;
(4) A mammogram for any woman, upon the recommendation of aphysician, where such woman, her mother or her sister has a prior historyof breast cancer.
3. Coverage and benefits related to mammography as required by thissection shall be at least as favorable and subject to the same dollarlimits, deductibles, and co-payments as other radiological examinations.
(L. 1990 S.B. 742 § 1, A.L. 1991 H.B. 385, et al., A.L. 1995 S.B. 27)CROSS REFERENCE:
Mammography and other services also required coverage, RSMo 376.995