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Arkansas Code Title 23. Public Utilities and Regulated Industries § 23-79-1303. Coverage for prostate cancer screening required

Current as of March 28, 2024 | Updated by Findlaw Staff

(a)(1) A health benefit plan that is offered, issued, or renewed in this state on or after January 1, 2010, and that provides coverage to men forty (40) years of age or older in this state shall provide coverage for screening for the early detection of prostate cancer in men forty (40) years of age and older according to the National Comprehensive Cancer Network guidelines, as in effect on January 1, 2009.

(2) The coverage for prostate cancer screening required under subdivision (a)(1) of this section:

(A) Is not subject to policy deductibles; and

(B) Shall not exceed the actual cost of the prostate cancer screening up to the maximum allowable cost per screening.

(b) The coverage for prostate cancer screening required under subsection (a) of this section shall be offered as follows:

(1) The prostate cancer screening shall be performed by a qualified medical professional; and

(2)(A) The coverage shall provide at least one (1) screening per year for any man forty (40) years of age or older according to the National Comprehensive Cancer Network guidelines, as in effect on January 1, 2023.

(B) If additional clinical recommendations for prostate cancer screenings are recognized by medical science to reduce the risk of prostate cancer diagnoses and are included in updated guidelines published by the National Comprehensive Cancer Network, then the Insurance Commissioner may adopt the updated guidelines by rule.

(c) The coverage for prostate cancer screening required under subsection (a) of this section does not diminish or limit diagnostic benefits otherwise allowable under a health benefit plan.

(d) If a medical practitioner recommends that an insured, a subscriber, or an enrollee undergo a prostate specific antigen blood test, coverage may not be denied on the ground that the insured, subscriber, or enrollee has already had a digital rectal examination and the examination result was negative.

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Cite this article: FindLaw.com - Arkansas Code Title 23. Public Utilities and Regulated Industries § 23-79-1303. Coverage for prostate cancer screening required - last updated March 28, 2024 | https://codes.findlaw.com/ar/title-23-public-utilities-and-regulated-industries/ar-code-sect-23-79-1303/

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