(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: (1) An individual who experiences a change in bowel habits, rectal bleeding or stomach cramps that are persistent; or (2) 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 16. West Virginia Public Employees Insurance Act
§5-16-1. Short Title; Legislative Intent
§5-16-5a. Retiree Premium Subsidy From Retiree Health Benefit Trust for Hires Prior to July 1, 2010
§5-16-5b. Creation of Trust for Retirees Hired on or After July 1, 2010
§5-16-7b. Coverage for Telehealth Services
§5-16-7c. Required Coverage for Reconstruction Surgery Following Mastectomies
§5-16-7d. Coverage for Patient Cost of Clinical Trials
§5-16-7g. Coverage for Prescription Insulin Drugs
§5-16-8. Conditions of Insurance Program
§5-16-11. To Whom Benefits Paid
§5-16-12. Misrepresentation by Employer, Employee or Provider; Penalty
§5-16-12a. Inspections; Violations and Penalties
§5-16-12b. Privileges and Immunity
§5-16-14. Program Qualifying for Favorable Federal Income Tax Treatment
§5-16-16. Preferred Provider Plan
§5-16-17. Preexisting Conditions Not Covered; Defined
§5-16-22. Permissive Participation; Exemptions
§5-16-28. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs