Section 432:1-605 - [Effective 7/1/2025] Mammogram screening(a) Notwithstanding any provision to the contrary, each policy, contract, plan, or agreement issued on or after February 1, 1991, except for policies that only provide coverage for specified diseases or other limited benefit coverage, but including policies issued by companies subject to chapter 431, article 10A, part II and chapter 432, article 1 shall provide coverage for screening by low-dose mammography for occult breast cancer as follows: (1) For women forty years of age and older, an annual mammogram; and(2) For a woman of any age with a history of breast cancer or whose mother or sister has had a history of breast cancer, a mammogram upon the recommendation of the woman's physician.(b) The services provided in subsection (a) are subject to any coinsurance provisions that may be in force in these policies, contracts, plans, or agreements; provided that the member's dollar limits, deductibles, and copayments for services shall be on terms at least as favorable to the member as those applicable to other radiological examinations.(c) For purposes of this section, "low-dose mammography" means the x-ray examination of the breast using equipment dedicated specifically for mammography, including but not limited to the x-ray tube, filter, compression device, screens, films, and cassettes, with an average radiation exposure delivery of less than one rad mid-breast, with two views for each breast.(d) An insurer may provide the services required by this section through contracts with providers; provided that the contract is determined to be a cost-effective means of delivering the services without sacrifice of quality and meets the approval of the director of health.Amended by L 2024, c 103,§ 2, eff. 7/1/2025.L 1990, c 112, §3; am L 1994, c 279, §3; am L 1999, c 13, §3 Director of health to monitor the mammogram screening services to assure that the demand for screening does not exceed the ability of the medical community to safely provide the services. L 1990, c 112, §5.
This section is set out more than once due to postponed, multiple, or conflicting amendments. Sunset evaluations modified, see §§ 26H-4, 5.