§ 27-13-7-16 — Prostate specific antigen test

Indiana § 27-13-7-16

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 13: HEALTH MAINTENANCE ORGANIZATIONS
• Ch. 7: Requirements for Group Contracts, Individual Contracts,

Text

(a) As used in this section, "prostate specific
antigen test" means a standard blood test performed to determine the
level of prostate specific antigen in the blood.
(b) Except as provided in subsection (f), a health maintenance
organization issued a certificate of authority in Indiana shall provide
prostate specific antigen testing as a covered service under every group
contract that provides coverage for basic health care services.
(c) Except as provided in subsection (f), the coverage required
under subsection (b) must include the following:
(1) At least one (1) prostate specific antigen test annually for a
male enrollee who is at least fifty (50) years of age.
(2) At least one (1) prostate specific antigen test annually for a
male enrollee who is less than fifty (50) years of age and who is
at high risk for prostate cancer according to the American Cancer
Society guidelines.
(d) Except as provided in subsection (f), the coverage that a health
maintenance organization must provide under this section may not be
subject to a contract provision that is less favorable to an enrollee than
a contract provision applying to physical illness generally under the
health maintenance organization contract.
(e) Except as provided in subsection (f), the coverage that a health
maintenance organization must provide under this section is in addition
to services specifically provided for x-rays, laboratory testing, or
wellness examinations.
(f) In the case of coverage that is not employer based, the health
maintenance organization must offer to provide the coverage described
in subsections (b) through (e).

Legislative History

As added by P.L.170-1999, SEC.6. Amended by P.L.124-2018, SEC.89.