Section 59A-46-52.2 – Pharmacist prescriptive authority services; reimbursement parity.
A carrier shall reimburse a participating provider that is a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who provides a service pursuant to an individual or group contract at the standard contracted rate that the carrier reimburses, for the same service under that individual or group contract, any licensed physician […]
Section 59A-46-50 – Coverage for autism spectrum disorder diagnosis and treatment.
A. An individual or group health maintenance contract that is delivered, issued for delivery or renewed in this state shall provide coverage to an enrollee for: (1) well-baby and well-child screening for diagnosing the presence of autism spectrum disorder; and (2) treatment of autism spectrum disorder through speech therapy, occupational therapy, physical therapy and applied […]
Section 59A-46-50.1 – Coverage for orally administered anticancer medications; limits on patient costs.
A. An individual or group health maintenance organization contract that is delivered, issued for delivery or renewed in this state and that provides coverage for cancer treatment shall provide coverage for a prescribed, orally administered anticancer medication that is used to kill or slow the growth of cancerous cells on a basis no less favorable […]
Section 59A-46-50.2 – Coverage of prescription eye drop refills.
A. An individual or group health maintenance organization contract that is delivered, issued for delivery or renewed in this state and that provides coverage for prescription eye drops shall not deny coverage for a renewal of prescription eye drops when: (1) the renewal is requested by the insured at least twenty-three days for a thirty-day […]
Section 59A-46-50.3 – Coverage for telemedicine services.
A. An individual or group health maintenance organization contract that is delivered, issued for delivery or renewed in this state shall provide coverage for services provided via telemedicine to the same extent that the contract covers the same services when those services are provided via in-person consultation or contact. A carrier shall not impose any […]
Section 59A-46-41.1 – Mastectomies and lymph node dissection; minimum hospital stay coverage required.
A. Each individual and group health maintenance contract delivered or issued for delivery in this state shall provide coverage for not less than forty-eight hours of inpatient care following a mastectomy and not less than twenty-four hours of inpatient care following a lymph node dissection for the treatment of breast cancer. B. Nothing in this […]
Section 59A-46-41.2 – Prior authorization for gynecological or obstetrical ultrasounds prohibited.
A. An individual or group health maintenance organization contract that is delivered, issued for delivery or renewed in this state and that provides coverage for gynecological or obstetrical ultrasounds shall not require prior authorization for gynecological or obstetrical ultrasounds. B. Nothing in this section shall be construed to require payment for a gynecological or obstetrical […]
Section 59A-46-42 – Coverage for cytologic and human papillomavirus screening.
A. Each individual and group health maintenance organization contract delivered or issued for delivery in this state shall provide coverage for cytologic and human papillomavirus screening to determine the presence of precancerous or cancerous conditions and other health problems. The coverage shall make available cytologic screening, as determined by the health care provider in accordance […]
Section 59A-46-42.1 – Coverage for the human papillomavirus vaccine.
A. An individual or group health maintenance organization contract delivered, issued for delivery or renewed in this state shall provide coverage for the human papillomavirus vaccine in accordance with the current standards of the federal centers for disease control and prevention. B. Coverage for the human papillomavirus vaccine may be subject to deductibles and coinsurance […]
Section 59A-46-43 – Coverage for individuals with diabetes.
A. Each individual and group health maintenance organization contract delivered or issued for delivery in this state shall provide coverage for individuals with insulin-using diabetes, with non-insulin-using diabetes and with elevated blood glucose levels induced by pregnancy. This coverage shall be a basic health care service and shall entitle each individual to the medically accepted […]