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§36-6060.8.


§36-6060.8.
   
   A. Any health benefit plan that is offered, issued or renewed in this
   state on or after January 1, 2000, which provides coverage to men
   forty (40) years old 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 group hospital
   or medical insurance coverage, a not-for-profit hospital or medical
   service or indemnity plan, a prepaid health plan, a health maintenance
   organization plan, a preferred provider organization plan, the State
   and Education Employees Group Health Insurance Plan, any program
   funded under Title XIX of the Social Security Act, or such other
   publicly funded program, and coverage provided by a Multiple Employer
   Welfare Arrangement (MEWA) or employee self-insured plan except as
   exempt under federal ERISA provisions. The term shall not include
   short-term, accident, fixed indemnity, or specified disease policies,
   disability income contracts, limited benefit or credit disability
   insurance, workers' compensation insurance coverage, automobile
   medical payment insurance, or insurance under which benefits are
   payable with or without regard to fault and which is required by law
   to be contained in any liability insurance policy or equivalent
   self-insurance.
   

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