§1060.15. Required coverage for positron emission tomography or other recommended
imaging for cancer
A. No health insurance issuer shall deny coverage of a positron emission tomography
or other recommended imaging for the purpose of diagnosis, treatment, appropriate
management, restaging, or ongoing monitoring of an individual's disease or condition if the
imaging is being requested for the diagnosis, treatment, or ongoing surveillance of cancer and
is recommended by nationally recognized clinical practice guidelines.
B. No health coverage plan that is renewed, delivered, or issued for delivery in this
state shall require an insured to undergo any imaging test for the purpose of diagnosis,
treatment, appropriate management, restaging, or ongoing monitoring of an insured's disease
or condition of cancer that is not recommended by nationally recognized clinical practice
guidelines, as a condition precedent to receiving a positron emission tomography or other
recommended imaging, when the positron emission tomography or other recommended
imaging is recommended by the guidelines provided by this Subpart.
C. The coverage provided in this Section may be subject to annual deductibles,
coinsurance, and copayment provisions as are consistent with those established under the
health coverage plan.
Acts 2023, No. 254, §1.