§ 23-79-1207 — Cost-sharing

(a) To encourage colorectal cancer screenings, patients and healthcare providers shall not be required to meet burdensome criteria or overcome significant obstacles to obtain coverage. (b) (1) An individual shall not be required to pay an additional deductible or coinsurance for testing that is greater than an annual deductible or coinsurance established for similar benefits. (2) (A) Beginning on and after January 1, 2022, a healthcare policy offered to an employee at the time of hiring or healthcare policy renewal shall not contain a cost-sharing requirement for a follow-up colonoscopy. (B) A covered person shall not be subject to a deductible, coinsurance, or any other cost-sharing requirement for services received from participating providers under a healthcare policy following an abnormal noncolonoscopy screening test, as an initial screening test is not considered complete until a follow-up colonoscopy is performed. (c) If the program or contract does not cover a similar benefit, a deductible or coinsurance shall not be set at a level that materially diminishes the value of the colorectal cancer benefit required under this subchapter. (d) Reimbursement to healthcare providers for colorectal cancer screenings provided under this section shall be equal to or greater than reimbursement to healthcare providers under Medicare, Title XVII of the Social Security Act, 42 U.S.C. § 1395 et seq., as it existed on January 1, 2021.

Legislative History

Amended by Act 2021, No. 779,§ 5, eff. 1/1/2022. Acts 2005, No. 2236, § 2.