Sec. 1376.003. MINIMUM COVERAGE REQUIRED. (a) A health benefit plan that provides coverage for screening medical procedures must provide the minimum coverage required by this section to each covered individual: (1) who is: (A) a male older than 45 years of age and younger than 76 years of age; or (B) a female older than 55 years of age and younger than 76 years of age; and (2) who: (A) is diabetic; or (B) has a risk of developing coronary heart disease, based on a score derived using the Framingham Heart Study coronary prediction algorithm, that is intermediate or higher. (b) The minimum coverage required to be provided under this section is coverage of up to $200 for one of the following noninvasive screening tests for atherosclerosis and abnormal artery structure and function every five years, performed by a laboratory that is certified by a national organization recognized by the commissioner by rule for the purposes of this section: (1) computed tomography (CT) scanning measuring coronary artery calcification; or (2) ultrasonography measuring carotid intima-media thickness and plaque.
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