(a) Notwithstanding any provision of any policy, provision, contract, plan or agreement applicable to this article, reimbursement or indemnification for colorectal cancer examinations and laboratory testing may not be denied for any nonsymptomatic person fifty years of age or older, or a symptomatic person under fifty years of age, when reimbursement or indemnity for laboratory or X-ray services are covered under the policy and are performed for colorectal cancer screening or diagnostic purposes at the direction of a person licensed to practice medicine and surgery by the Board of Medicine. The tests are as follows: An annual fecal occult blood test, a flexible sigmoidoscopy repeated every five years, a colonoscopy repeated every ten years and a double contrast barium enema repeated every five years.
(b) A symptomatic person is defined as: (i) An individual who experiences a change in bowel habits, rectal bleeding or stomach cramps that are persistent; or (ii) an individual who poses a higher than average risk for colorectal cancer because he or she has had colorectal cancer or polyps, inflammatory bowel disease, or an immediate family history of such conditions.
(c) The same deductibles, coinsurance, network restrictions and other limitations for covered services found in the policy, provision, contract, plan or agreement of the covered person may apply to colorectal cancer examinations and laboratory testing.
Structure West Virginia Code
Article 25. Health Care Corporations
§33-25-1. Declaration of Policy
§33-25-3. Incorporation; Purposes; Name; Limitations
§33-25-5. Exemption From Taxes
§33-25-6. Supervision and Regulation by Insurance Commissioner; Exemption From Insurance Laws
§33-25-6a. Applicability of Insurance Fraud Prevention Act
§33-25-8a. Third Party Reimbursement for Mammography or Pap Smear or Human Papilloma Virus Testing
§33-25-8b. Third Party Reimbursement for Rehabilitation Services
§33-25-8c. Third Party Payment for Child Immunization Services
§33-25-8d. Coverage of Emergency Services
§33-25-8e. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
§33-25-8f. Required Use of Mail-Order Pharmacy Prohibited
§33-25-8g. Third-Party Reimbursement for Kidney Disease Screening
§33-25-8h. Required Coverage for Dental Anesthesia Services
§33-25-8j. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications
§33-25-8k. Eye Drop Prescription Refills
§33-25-8l. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs
§33-25-8n. Coverage for Amino Acid-Based Formulas
§33-25-8o. Substance Use Disorder
§33-25-8p. Prior Authorization
§33-25-8q. Fairness in Cost-Sharing Calculation
§33-25-8r. Mental Health Parity
§33-25-8s. Incorporation of the Health Benefit Plan Network Access and Adequacy Act
§33-25-8t. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs
§33-25-11. Rules and Regulations
§33-25-14. Advancement of Money to Corporation
§33-25-16. Disposition of Fees and Charges
§33-25-17. Bonds of Corporation Officers and Employees
§33-25-18. Annual Audited Financial Report
§33-25-19. Administrative Supervision
§33-25-20. Policies Discriminating Among Health Care Providers
§33-25-22. Assignment of Certain Benefits in Dental Care Insurance Coverage