CHAPTER 405

FORMERLY

SENATE BILL NO. 319

AS AMENDED BY SENATE AMENDMENT NOS. 1 AND 2

AN ACT TO AMEND THE DELAWARE INSURANCE CODE TO REQUIRE COVERAGE OF THE CA-125 TEST FOR MONITORING OVARIAN CANCER TREATMENT.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend Chapter 33, Title 18 of the Delaware Code by adding a new Section 3337 as follows:

13337. Coverage of Cancer Monitoring Test

(a) Every individual health, sickness or accident Insurance policy, contract or certificate, which is delivered or issued for delivery in this State by any health insurer, health service corporation or health maintenance organization, and which provide benefits for outpatient services, shall provide to covered persons residing in this State a benefit for CA-125 monitoring of ovarian cancer subsequent to treatment. Such monitoring shall be deemed a covered service, notwithstanding any policy exclusions for services which are considered experimental or investigative; provided, however, that nothing contained herein shall be deemed to provide coverage for routine screening.

(b) Nothing in this section shall prevent the operation of such policy •provisions as deductibles, coinsurance, allowable charge limitations,
coordination of benefits or provisions restricting coverage to services by licensed, certified or carrier-approved providers or facilities.

(a) This act shall apply to all policies, contracts or certificates
which
are issued, renewed, modified, altered, amended or reissued after the effective date of this Act."

Section 2. Amend Chapter 35, Title 18 of the Delaware Code by adding a new Section 3554 which shall read as follows:

13554. Coverage of Cancer Monitoring Tests.

(a) All group and blanket health insurance policies, which are
delivered or issued for delivery in this State by any health insurer, health service corporation or health maintenance organization, and which provide benefits for outpatient services, shall provide to covered persons residing or having their principal place of employment in this State, a benefit for CA-125 monitoring of ovarian cancer subsequent to treatment. Such monitoring -shall be deemed a covered service, notwithstanding any policy exclusions for services which are considered experimental or investigative; provided, however, that nothing contained herein shall deemed to provide coverage for routine screening.

(a) Nothing in this section shall prevent the operation of such policy provisions such as deductibles, coinsurance, allowable charge limitations, coordination of benefits or provisions restricting coverage to services by licensed, certified or carrier-approved providers or facilities.

(b) This act shall apply to all policies, contracts or certificates
which
are issued, renewed, modified, altered, amended or reissued after the effective date of this Act."

Section 3. Nothing in this Act shall apply to accident-only, specified

disease, hospital indemnity, Medicare supplement, long-term care, or other limited benefit health insurance policies.

Section 4. This Act shall become effective on September 1, 1994.

Approved July 14, 1994.