2010 Tennessee Code
Title 56 - Insurance
Chapter 7 - Policies and Policyholders
Part 25 - Mandated Insurer or Plan Options
56-7-2502 - Mammography screening.

56-7-2502. Mammography screening.

(a)  Any individual, franchise, blanket or group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society, or health maintenance organization that provides coverage for surgical services for a mastectomy, and that is delivered, issued for delivery, amended or renewed on or after July 1, 1989, shall also provide coverage for mammography screening performed on dedicated equipment for diagnostic purposes on referral by a patient's physician according to the following guidelines:

     (1)  A baseline mammogram for women thirty-five (35) to forty (40) years of age;

     (2)  A mammogram every two (2) years, or more frequently based on the recommendation of the woman's physician, for women forty (40) to fifty (50) years of age; and

     (3)  A mammogram every year for women fifty (50) years of age and over.

(b)  Any increase in expenditure requirements on a municipality or a county resulting from this section shall be appropriated from funds that the municipality or county receives from the state-shared taxes that are not earmarked by statute for a particular purpose.

(c)  (1)  This section shall not apply to medicare supplemental policies unless mammography is covered under medicare. This section shall not apply to policies that provide only hospital indemnity benefits or to policies that provide only benefits for specified accidents. Insurance policies that provide benefits only for specified diseases and that cover mastectomies shall be subject to the requirements of this section, unless the owner of the policy has other insurance that provides mammography coverage as guaranteed by this section.

     (2)  The issuer of the specified disease policy has the burden of proving that the insured has other insurance that covers mammography to the extent guaranteed by this section.

[Acts 1989, ch. 160, §§ 1, 3; 1990, ch. 859, § 1; 1992, ch. 984, § 3; T.C.A., § 56-7-1012.]  

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