Maine § 24-A §2745-A Coverage for screening mammograms and diagnostic and supplemental breast examinations

Maine Statutes

§ 24-A §2745-A — Coverage for screening mammograms and diagnostic and supplemental breast examinations

Maine·Title 24-A MAINE INSURANCE CODE·Ch. 33 HEALTH INSURANCE CONTRACTS

1.Definition. 1-A. Definitions. For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings.

2.Required coverage. All individual insurance policies that cover radiologic procedures, except those designed to cover only specific diseases, accidental injury or dental procedures, must provide coverage for screening mammograms performed by providers that meet the standards established by the Department of Health and Human Services rules relating to radiation protection. The policies must reimburse for screening mammograms performed at least once a year for women 40 years of age and over. 2-A. No cost-sharing requirements. An individual insurance policy may not impose any cost-sharing requirements on a screening mammogram, diagnosti

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1.
Definition.
1-A.
Definitions.
For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings.
2.
Required coverage.
All individual insurance policies that cover radiologic procedures, except those designed to cover only specific diseases, accidental injury or dental procedures, must provide coverage for screening mammograms performed by providers that meet the standards established by the Department of Health and Human Services rules relating to radiation protection. The policies must reimburse for screening mammograms performed at least once a year for women 40 years of age and over.
2-A.
No cost-sharing requirements.
An individual insurance policy may not impose any cost-sharing requirements on a screening mammogram, diagnostic breast examination or supplemental breast examination performed by a provider in accordance with this section. This subsection does not apply to an individual policy offered for use with a health savings account unless the federal Internal Revenue Service determines that the requirements in this subsection are permissible in a high deductible health plan as defined in the federal Internal Revenue Code, Section 223(c)(2).
3.
Application.
This section applies to all policies, contracts and certificates that cover radiologic procedures, except those policies that cover only dental procedures, accidental injury or specific diseases, executed, delivered, issued for delivery, continued or renewed in this State on or after March 1, 1991. For purposes of this section, all policies and contracts are deemed to be renewed no later than the next yearly anniversary of the policy or contract date.
4.
Reports.
Each insurer that issues policies subject to this section shall report to the superintendent its experience for each calendar year beginning with 1991 not later than April 30th of the following calendar year. The report must include the information required and be presented in the form prescribed by the superintendent. The report must include the amount of claims paid in this State for services required by this section. The superintendent shall compile this data in an annual report and submit the report to the joint standing committee of the Legislature having jurisdiction over banking and insurance matters.

Maine § 24-A §2745-A (Coverage for screening mammograms and diagnostic and supplemental breast examinations) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Legislative History

PL 1989, c. 875, §I3 (NEW). PL 1991, c. 156, §1 (AMD). PL 1991, c. 701, §6 (AMD). PL 1997, c. 408, §3 (AMD). PL 1997, c. 408, §8 (AFF). PL 2003, c. 689, §B6 (REV). PL 2007, c. 153, §1 (AMD). PL 2007, c. 153, §5 (AFF). PL 2023, c. 338, §§1-4 (AMD). PL 2023, c. 338, §13 (AFF).