A. A group health maintenance organization contract, other than a small group health maintenance organization contract, that is delivered, issued for delivery or renewed in this state shall provide coverage for eligible enrollees to receive a heart artery calcium scan.

B. Coverage provided pursuant to this section shall:

(1)     be limited to the provision of a heart artery calcium scan to an eligible enrollee to be used as a clinical management tool;

(2)     be provided every five years if an eligible enrollee has previously received a heart artery calcium score of zero; and

(3)     not be required for future heart artery calcium scans if an eligible enrollee receives a heart artery calcium score greater than zero.

C. At its discretion or as required by law, a carrier may offer or refuse coverage for further cardiac testing or procedures for eligible enrollees based upon the results of a heart artery calcium scan.

D. The provisions of this section do not apply to short-term travel, accident-only or limited or specified-disease policies, plans or certificates of health insurance.

E. As used in this section:

(1)     “eligible enrollee” means an enrollee who:

(a) is a person between the ages of forty-five and sixty-five; and

(b) has an intermediate risk of developing coronary heart disease as determined by a health care provider based upon a score calculated from an evidence- based algorithm widely used in the medical community to assess a person’s ten-year cardiovascular disease risk, including a score calculated using a pooled cohort equation;

(2)     “health care provider” means a physician, physician assistant, nurse practitioner or other health care professional authorized to furnish health care services within the scope of the professional’s license; and

(3)     “heart artery calcium scan” means a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function.