§ 22:1028.2 — Required coverage for diagnostic imaging

Louisiana § 22:1028.2

• Jurisdiction: Louisiana
• Title 22: Insurance

Text

§1028.2. Required coverage for diagnostic imaging
A.(1) Any health coverage plan delivered or issued for delivery in this state shall
include coverage for diagnostic imaging at the same level of coverage provided for the
minimum mammography examination pursuant to R.S. 22:1028.
(2) The health coverage plan may require a referral by the treating physician based
on medical necessity for the diagnostic imaging to be eligible for the coverage required
pursuant to Paragraph (1) of this Subsection.
(3) Any coverage required pursuant to the provisions of this Section shall not be
subject to any policy or health coverage plan deductible amount.
B. For purposes of this Section:
(1) "Diagnostic imaging" means a diagnostic mammogram, contrast-enhanced
mammogram, breast magnetic resonance imaging, or breast ultrasound screening for breast
cancer designed to evaluate an abnormality in the breast that is any of the following:
(a) Seen or suspected from a screening examination for breast cancer.
(b) Detected by another means of examination.
(c) Suspected based on the medical history or family medical history of the
individual or additional factors that may increase the individual's risk of breast cancer.
(2) "Health coverage plan" means any hospital, health, or medical expense insurance
policy, hospital or medical service contract, employee welfare benefit plan, contract, or other
agreement with a health maintenance organization or a preferred provider organization,
health and accident insurance policy, or any other insurance contract of this type in this state,
including a group insurance plan, a self-insurance plan, and the Office of Group Benefits
programs. "Health coverage plan" shall not include a plan providing coverage for excepted
benefits as defined in R.S. 22:1061, limited benefit health insurance plans, and short-term
policies that have a term of less than twelve months.
C. Any provision in a health insurance policy, benefit program, or health coverage
plan delivered, renewed, issued for delivery, or otherwise contracted for in this state which
is contrary to the provisions of this Section shall, to the extent of the conflict, be void.

Legislative History

Acts 2019, No. 119, §1, eff. Jan, 1, 2021; Acts 2024, No. 174, §1, eff. May 23, 2024.