(a) As used in this Code section, the term: (1) "At risk for ovarian cancer" means: (A) Having a family history: (i) With one or more first or second-degree relatives with
ovarian cancer; (ii) Of clusters of women relatives with breast cancer; (iii) Of nonpolyposis colorectal cancer; or (B) Testing positive for BRCA1 or BRCA2 mutations. (2) "Health benefit policy" means any individual or group plan,
policy, or contract for health care services issued, delivered,
issued for delivery, executed, or renewed in this state, including
but not limited to those contracts executed by the State of
Georgia on behalf of state employees under Article 1 of Chapter 18
of Title 45, by an insurer. (3) "Insurer" means an accident and sickness insurer, fraternal
benefit society, hospital service corporation, medical service
corporation, health care corporation, health maintenance
organization, preferred provider organization, provider sponsored
health care corporation, managed care entity, or any similar
entity authorized to issue contracts under this title or to
provide health benefit policies. (4) "Surveillance tests" means annual screening using: (A) CA-125 serum tumor marker testing; (B) Transvaginal ultrasound; and (C) Pelvic examination. (b) Every health benefit policy that is delivered, issued, issued
for delivery, executed, or renewed in this state or approved for
issuance or renewal in this state by the Commissioner on or after
July 1, 2001, shall provide coverage for surveillance tests for
women age 35 and over at risk for ovarian cancer. (c) The benefits provided in this Code section shall be subject to
the same annual deductibles or coinsurance established for all other
covered benefits within a given health benefit policy. (d) A physician who assesses a patient for ovarian cancer and such
patient is at risk for ovarian cancer is encouraged to advise such
patient of the availability of surveillance tests in accordance with
the practices of the profession generally under similar conditions
and like surrounding circumstances. |