2019 Louisiana Laws
Revised Statutes
Title 22 - Insurance
§1028.2. Required coverage for diagnostic imaging

RS 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 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.

(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.

Acts 2019, No. 119, §1, eff. Jan, 1, 2021.