56-7-2606 - Coverage for chlamydia screening.
56-7-2606. Coverage for chlamydia screening.
(a) The general assembly finds that chlamydia is a sexually transmitted disease that may cause serious complications in persons infected with it, including pelvic inflammatory disease, infertility, and ectopic pregnancy. Pregnant women infected with chlamydia may suffer from symptoms such as stillbirths, low birth weight babies, and other serious physical and mental complications for their infants. Chlamydia is often asymptomatic in women and cannot be detected except with special, though inexpensive, screening tests. Cure of chlamydia is usually both easy and inexpensive. The general assembly further finds that having health care insurance and managed care plan coverage of annual chlamydia screening tests for females in conjunction with covered pap smears in the age group most likely to be infected with chlamydia will encourage the testing and treatment needed to detect and cure this destructive disease and result in a marked improvement in the general health of the citizens of this state.
(b) As used in this section, unless the context otherwise requires:
(1) Chlamydia screening test means any laboratory test of the urogenital tract that specifically detects for infection by one (1) or more agents of chlamydia trachomatis and which test is approved for those purposes by the federal food and drug administration;
(2) Insurer means an insurance benefit plan, a fraternal benefit society, a nonprofit hospital service corporation, a nonprofit medical service corporation, a health care plan, a health maintenance organization, a managed care organization, or any similar entity by whatever name called; and
(3) Policy means a major medical accident and sickness insurance policy, health benefit plan, contract, or policy issued by an insurer, except a disability income policy, specified disease policy, hospital indemnity policy, credit insurance policy, accident only policy, or other limited benefit plan policy or contract.
(c) (1) Every insurer authorized to issue an individual or group accident and sickness insurance policy in this state that provides major medical insurance coverage and that includes coverage for any female shall make available on an optional basis as part of or as an endorsement to each such policy that is issued, delivered, issued for delivery, or renewed in this state on or after July 1, 1999, coverage for one (1) annual chlamydia screening test in conjunction with an annual pap smear for covered females who are not more than twenty-nine (29) years of age if the screening test is determined to be medically necessary.
(2) The chlamydia screening test coverage may be subject to exclusions, reductions, or other limitations as to coverages, deductibles, or coinsurance provisions approved by the commissioner.
(3) Nothing in this subsection (c) shall be construed to prohibit the issuance of accident and sickness insurance policies that provide benefits greater than or more favorable to the insured than those benefits established pursuant to subdivision (c)(1), nor to prohibit any managed care plan contract from providing benefits greater than or more favorable to the insured than those benefits established pursuant to subdivision (c)(1), from having cost-sharing arrangements or to otherwise change the contractual relations between an insurer and their insureds or covered persons by whatever name called.
(4) Nothing contained in this subsection (c) shall be construed to prohibit any insurer from providing benefits greater than or more favorable to the covered females.
(5) The requirements of this subsection (c) with respect to a group or blanket accident and sickness insurance benefit plan, policy, or contract shall be satisfied if the coverage specified in this subsection (c) is made available to the master policyholder of the plan, policy, or contract. Nothing in this subsection (c) shall be construed to require the group insurer, nonprofit corporation, health care plan, health maintenance organization, managed care organization, or master policyholder to provide or to make available the coverage to any certificate holder insured under the group policy, plan, or contract.
(6) Nothing contained in this subsection (c) shall be deemed to prohibit the payment of different levels of benefits or having differences in coinsurance percentages applicable to benefit levels for services provided by preferred and nonpreferred providers in accordance with preferred provider arrangements.
(d) The commissioner is authorized to promulgate rules and regulations to effectuate the purposes of this section. The rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
[Acts 1999, ch. 61, § 2.]