Rhode Island § 27-18-41 - Accident and Sickness Insurance Policies

§ 27-18-41. Mammograms and pap smears — Coverage mandated.

(a)(1) Every individual or group hospital or medical expense insurance policy or individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state shall provide coverage for mammograms and pap smears, in accordance with guidelines established by the American Cancer Society.

(2) Notwithstanding the provisions of this chapter, every individual or group hospital or medical insurance policy or individual or group hospital or medical services plan contract delivered, issued for delivery, or renewed in this state shall pay for:

(i) Two (2) screening mammograms per year when recommended by a physician for women who have been treated for breast cancer within the last five (5) years or are at high risk of developing breast cancer due to genetic predisposition (BRCA gene mutation or multiple first-degree relatives) or high risk lesion on prior biopsy (lobular carcinoma in situ) or atypical ductal hyperplasia; and

(ii) Any screening deemed medically necessary for proper breast cancer screening in accordance with applicable American College of Radiology guidelines including, but not limited to, magnetic resonance imaging, ultrasound, or molecular breast imaging for any person who has received notice pursuant to § 23-12.9-2 of the existence of dense breast tissue.

(b) This section shall not apply to insurance coverage providing benefits for: (1) Hospital confinement indemnity; (2) Disability income; (3) Accident only; (4) Long-term care; (5) Medicare supplement; (6) Limited benefit health; (7) Specified disease indemnity; (8) Sickness or bodily injury or death by accident or both; and (9) Other limited benefit policies.