(1) An insurer offering a health insurance policy that covers hospital, medical or surgical expenses, other than coverage limited to expenses from accidents or specific diseases, shall provide coverage for the following colorectal cancer screening examinations and laboratory tests:
(a) For an insured 50 years of age or older:
(A) One fecal occult blood test per year plus one flexible sigmoidoscopy every five years;
(B) One colonoscopy every 10 years; or
(C) One double contrast barium enema every five years.
(b) For an insured who is at high risk for colorectal cancer, colorectal cancer screening examinations and laboratory tests as recommended by the treating physician.
(2) For the purposes of subsection (1)(b) of this section, an individual is at high risk for colorectal cancer if the individual has:
(a) A family medical history of colorectal cancer;
(b) A prior occurrence of cancer or precursor neoplastic polyps;
(c) A prior occurrence of a chronic digestive disease condition such as inflammatory bowel disease, Crohn’s disease or ulcerative colitis; or
(d) Other predisposing factors.
(3) Health care service contractors, as defined in ORS 750.005, and trusts carrying out a multiple employer welfare arrangement, as defined in ORS 750.301, are also subject to this section. [Formerly 743.799]
Note: See 743A.001.
Note: 743A.124 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743A or any series therein. See Preface to Oregon Revised Statutes for further explanation.
Section: Previous 743A.088 743A.090 743A.100 743A.104 743A.108 743A.110 743A.120 743A.124 743A.140 743A.144 743A.148 743A.160 743A.164 743A.168 743A.180 NextLast modified: August 7, 2008