1. Colorectal cancer screening. For the purposes of this section, “colorectal cancer screening” means all colorectal cancer examinations and laboratory tests recommended by a health care provider in accordance with the most recently published colorectal cancer screening guidelines of a national cancer society.

[PL 2019, c. 86, §7 (AMD).]

Terms Used In Maine Revised Statutes Title 24-A Sec. 4254

  • health insurance: means insurance of human beings against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto, including provision for the mental and emotional welfare of human beings by defraying the costs of legal services only to the extent provided for in chapter 38. See Maine Revised Statutes Title 24-A Sec. 704
  • Health maintenance organization: means a public or private organization that is organized under the laws of the Federal Government, this State, another state or the District of Columbia or a component of such an organization, and that:
A. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Infant: means a person who has not attained the age of 18 years. See Maine Revised Statutes Title 1 Sec. 72
  • Provider: means a physician, hospital or person that is licensed or otherwise authorized in this State to furnish health care services. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • 2. Required coverage. All health maintenance organization individual and group health insurance policies, contracts and certificates must provide coverage for colorectal cancer screening for asymptomatic individuals who are:
    A. At average risk for colorectal cancer according to the most recently published colorectal cancer screening guidelines of a national cancer society; or [PL 2019, c. 86, §8 (AMD).]
    B. At high risk for colorectal cancer. [PL 2019, c. 86, §9 (AMD).]

    [PL 2019, c. 86, §§8, 9 (AMD).]

    3. Billing. If a colonoscopy is recommended by a health care provider as the colorectal cancer screening test in accordance with this section and a lesion is discovered and removed during that colonoscopy, the health care provider must bill the insurance company for a screening colonoscopy as the primary procedure.

    [PL 2007, c. 516, §4 (NEW); PL 2007, c. 516, §5 (AFF).]

    Revisor’s Note: §4254. Coverage for medically necessary infant formula (As enacted by PL 2007, c. 595, §4 is REALLOCATED TO TITLE 24-A, SECTION 4256)
    SECTION HISTORY

    PL 2007, c. 516, §4 (NEW). PL 2007, c. 516, §5 (AFF). PL 2007, c. 595, §4 (NEW). PL 2007, c. 595, §5 (AFF). PL 2007, c. 695, Pt. C, §16 (RAL). PL 2019, c. 86, §§7-9 (AMD).