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ACT OF THE GENERAL ASSEMBLY 2007-2008

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NO. 160.  AN ACT RELATING TO MAMMOGRAPHY PATIENT COST CONTAINMENT.

(S.340)

It is hereby enacted by the General Assembly of the State of Vermont:

Sec. 1.  8 V.S.A. § 4100a is amended to read:

§ 4100a.  MAMMOGRAMS; COVERAGE REQUIRED

(a)  Insurers shall provide coverage for screening by low-dose mammography for the presence of occult breast cancer, as provided by this subchapter.  Benefits provided shall be at least as favorable as coverage for other radiological examinations and subject to the same dollar limits, deductibles, and coinsurance factors within the provisions of the policy cover the full cost of the mammography service, subject to a co-payment no greater than the co-payment applicable to care or services provided by a primary care physician under the insured’s policy, provided that no co-payment shall exceed $25.00.  Mammography services shall not be subject to deductible or coinsurance requirements.

(b)  For females 50 40 years or older, coverage shall be provided for an annual screening. For females less than 50 40 years of age, coverage for screening shall be provided upon recommendation of a health care provider.

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Sec. 2.  APPLICABILITY AND EFFECTIVE DATE

This act shall take effect on October 1, 2008 and shall apply to all health benefit plans on and after October 1, 2008 on such date as a health insurer offers, issues, or renews the health benefit plan, but in no event later than October 1, 2009.

Approved:  May 20, 2008



Published by:

The Vermont General Assembly
115 State Street
Montpelier, Vermont


www.leg.state.vt.us