COVERAGE BY MANAGED CARE ORGANIZATIONS

Section 695G.150 - Authorization of recommended and covered health care services required
Section 695G.155 - Managed care organization required to offer and issue plan regardless of health status of persons; prohibited acts; authority to include wellness program in plan that offers discounts based on health status under certain circumstances
Section 695G.160 - Written criteria concerning coverage of health care services and standards for quality of health care services
Section 695G.162 - Required provision concerning coverage for services provided through telehealth to same extent and in same amount as though provided in person or by other means; exception; prohibited acts
Section 695G.163 - Coverage for prescription drugs: Provision of notice and information regarding use of formulary
Section 695G.1635 - Plan covering prescription drugs: Required actions by managed care organization related to acquisition of prescription drugs for certain insureds residing in area for which emergency or disaster has been declared
Section 695G.164 - Required provision in certain plans concerning coverage for continued medical treatment; exceptions; regulations
Section 695G.1645 - Required provision in plan for group coverage concerning coverage for autism spectrum disorders for certain persons; prohibited acts
Section 695G.166 - Plan covering prescription drugs prohibited from limiting or excluding coverage for prescription drug previously approved for medical condition of insured; exceptions
Section 695G.1665 - Required provision in plan covering prescription drugs concerning coverage for prescription drugs irregularly dispensed for purpose of synchronization of chronic medications; prohibited acts; exception
Section 695G.167 - Plan covering treatment of cancer through use of chemotherapy: Prohibited acts related to orally administered chemotherapy
Section 695G.1675 - Plan covering prescription drug for treatment of cancer or cancer symptom that is part of step therapy protocol: Managed care organization required to allow insured or attending practitioner to apply for exemption from step therapy protocol in certain circumstances; procedure for applying for and granting exemption
Section 695G.168 - Required provision in plan covering treatment of colorectal cancer concerning coverage for colorectal cancer screening
Section 695G.170 - Required provision concerning coverage for medically necessary emergency services at any hospital; prohibited acts
Section 695G.1705 - Required provision concerning coverage for drugs, laboratory testing and certain services related to human immunodeficiency virus; reimbursement of pharmacist for certain services
Section 695G.171 - Required provision concerning coverage for certain tests and vaccines relating to human papillomavirus; prohibited acts
Section 695G.1712 - Required provision concerning coverage for screening, genetic counseling and testing related to BRCA gene in certain circumstances
Section 695G.1713 - Required provision concerning coverage for mammograms for certain women; prohibited acts
Section 695G.1714 - Required provision concerning coverage for examination of person who is pregnant for certain diseases
Section 695G.1715 - Required provision concerning coverage for drug or device for contraception and related health services; prohibited acts; exceptions
Section 695G.1716 - Health care plan covering maternity care: Prohibited acts by managed care organization if insured is acting as gestational carrier; child deemed child of intended parent for purposes of plan
Section 695G.1717 - Required provision concerning coverage for certain services, screenings and tests relating to wellness; prohibited acts
Section 695G.172 - Plan covering prescription drugs: Denial of coverage prohibited for early refills of otherwise covered topical ophthalmic products
Section 695G.173 - Required provision concerning coverage for certain treatment received as part of clinical trial or study for treatment of cancer or chronic fatigue syndrome; authority of managed care organization to require certain information; immunity from liability
Section 695G.174 - Required provision concerning coverage for management and treatment of sickle cell disease and its variants; plan covering prescription drugs required to provide coverage for medically necessary prescription drugs to treat sickle cell disease and its variants
Section 695G.175 - Contracts for provision of emergency medical services, outpatient services or inpatient services with hospital or other facility that provides acute care in smaller city or county: Prohibited acts
Section 695G.176 - Plan covering anatomical gifts, organ transplants or treatments or services related to organ transplants: Prohibited acts by managed care organization if insured is person with disability
Section 695G.177 - Required provision in plans covering treatment of prostate cancer concerning coverage for prostate cancer screening; prohibited acts