Ind. Code § 5-10-8-7.8
Colorectal cancer testing coverage; exception for high deductible health plans
Redline — January 1, 2018 → current.View current text →
Current — January 1, 2023
As of January 1, 2018
Sec. 7.8. (a) As used in this section, "covered individual" means an individual who is:
Sec. 7.8. (a) As used in this section, "covered individual" means an individual who is:
(1) covered under a self-insurance program established under section 7(b) of this chapter to provide group health coverage; or
(1) covered under a self-insurance program established under section 7(b) of this chapter to provide group health coverage; or
(2) entitled to services under a contract with a health maintenance organization (as defined in IC 27-13-1-19) that is entered into or renewed under section 7(c) of this chapter.
(2) entitled to services under a contract with a health maintenance organization (as defined in IC 27-13-1-19) that is entered into or renewed under section 7(c) of this chapter.
(b) A:
(b) A:
(1) self-insurance program established under section 7(b) of this chapter to provide health care coverage; or
(1) self-insurance program established under section 7(b) of this chapter to provide health care coverage; or
(2) contract with a health maintenance organization that is entered into or renewed under section 7(c) of this chapter;
(2) contract with a health maintenance organization that is entered into or renewed under section 7(c) of this chapter;
must provide coverage for colorectal cancer examinations and laboratory tests for cancer for any nonsymptomatic covered individual, in accordance with the current American Cancer Society guidelines.
must provide coverage for colorectal cancer examinations and laboratory tests for cancer for any nonsymptomatic covered individual.
(c) For a covered individual who is:
(c) For a covered individual who is:
(1) at least fifty (50) years of age; or
(1) at least forty-five (45) years of age; or
(2) less than fifty (50) years of age and at high risk for colorectal cancer according to the most recent published guidelines of the American Cancer Society;
(2) less than forty-five (45) years of age and at high risk for colorectal cancer;
the coverage required under this section must meet the requirements set forth in subsection (d).
the coverage required under this section must meet the requirements set forth in subsection (d), except as provided in subsection (e).
(d) A covered individual may not be required to pay an additional deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit that is greater than an annual deductible or coinsurance established for similar benefits under a self-insurance program or contract with a health maintenance organization. If the program or contract does not cover a similar benefit, a deductible or coinsurance may not be set at a level that materially diminishes the value of the colorectal cancer examination and laboratory testing benefit required under this section.
(d) A covered individual may not be required to pay an additional deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit required by this section that is greater than an annual deductible or coinsurance established for similar benefits under the self-insurance program or contract with a health maintenance organization under which the covered individual is covered or entitled to services. If the program or contract does not cover a similar benefit, a deductible or coinsurance for the colorectal cancer examination and laboratory testing benefit may not be set at a level that materially diminishes the value of the colorectal cancer examination and laboratory testing benefit.
(e) The requirements imposed under this section do not apply to a high deductible health plan, as defined by Section 223 of the Internal Revenue Code. High deductible health plans described in this subsection may not excuse a deductible requirement with respect to colorectal cancer screening in a manner inconsistent with Section 223(c)(2)(C) of the Internal Revenue Code.
Official source: Indiana General Assembly. Reproduced from public-domain Indiana statutes; confirm against the official source for the current text. Not legal advice.