Maine § 2320-A. - Screening mammograms

§ 2320-A.. Screening mammograms

1.  Definition.  For purposes of this section, "screening mammogram" means a radiologic procedure that is provided to an asymptomatic woman for the purpose of early detection of breast cancer and that consists of 2 radiographic views per breast.

2.  Required coverage.  All individual and group nonprofit hospital and medical services plan contracts 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.

A.   [PL 1997, c. 408, §1 (RP); PL 1997, c. 408, §8 (AFF).]

B.   [PL 1997, c. 408, §1 (RP); PL 1997, c. 408, §8 (AFF).]

3.  Application.  This section applies to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.

4.  Reports.  Each nonprofit hospital and medical care service organization 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.

5.  No cost-sharing requirements.  A nonprofit hospital and medical care service organization may not impose any cost-sharing requirements on a screening mammogram 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 United States Internal Revenue Service determines that the requirements in this subsection are permissible in a high deductible health plan as defined in the United States Internal Revenue Code of 1986, Section 223(c)(2).