§ 23-79-1202 - Coverage -- Applicability.
23-79-1202. Coverage -- Applicability.
(a) A health care policy subject to this subchapter executed, delivered, issued for delivery, continued, or renewed in this state on or after August 1, 2005, shall include colorectal cancer examinations and laboratory tests within the policy's coverage.
(b) The coverage shall include colorectal cancer examinations and laboratory tests for:
(1) Covered persons who are fifty (50) years of age or older;
(2) Covered persons who are less than fifty (50) years of age and at high risk for colorectal cancer according to American Cancer Society colorectal cancer screening guidelines as they existed on January 1, 2005; and
(3) Covered persons experiencing the following symptoms of colorectal cancer as determined by a physician licensed under the Arkansas Medical Practices Act, 17-95-201 et seq., 17-95-301 et seq., and 17-95-401 et seq.:
(A) Bleeding from the rectum or blood in the stool; or
(B) A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts more than five (5) days.
(c) After August 1, 2005, each employer that offers a health care policy to employees shall offer all eligible employees at the time of hiring or health care policy renewal a policy that includes colorectal cancer examinations and laboratory tests within the coverage of the employee's health care policy.
(d) (1) The colorectal screening shall involve an examination of the entire colon, including:
(A) The following examinations or laboratory tests, or both:
(i) An annual fecal occult blood test utilizing the take-home multiple sample method, or an annual fecal immunochemical test in conjunction with a flexible sigmoidoscopy every five (5) years;
(ii) A double-contrast barium enema every five (5) years; or
(iii) A colonoscopy every ten (10) years; and
(B) Any additional medically recognized screening tests for colorectal cancer required by the Director of the Department of Health, determined in consultation with appropriate health care organizations.
(2) The covered person shall determine the choice of screening strategies in consultation with a health care provider.
(3) Colorectal screening examinations shall be according to the choices and frequency provided by this subsection for all other covered persons.
(e) Screenings shall be limited to the following guidelines for the management or subsequent need for follow-up colonoscopy:
(1) If the initial colonoscopy is normal, follow-up is recommended in ten (10) years;
(2) For individuals with one (1) or more neoplastic polyps or adenomatous polyps, assuming that the initial colonoscopy was complete to the cecum and adequate preparation and removal of all visualized polyps, follow-up is recommended in three (3) years;
(3) If single tubular adenoma of less than one centimeter (1 cm) is found, follow-up is recommended in five (5) years; and
(4) For patients with large sessile adenomas greater than three centimeters (3 cm), especially if removed in piecemeal fashion, follow-up is recommended in six (6) months or until complete polyp removal is verified by colonoscopy.