Okla. Stat. tit. 36, § 36-6060
This is the official text of Okla. Stat. tit. 36, § 36-6060, part of Oklahoma’s Stat. tit. 36, — part of the compiled statutory law of Oklahoma, published by the state as "Stat. tit. 36,." Browse the sections below, each linked to its official government source.
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Mammography screening and diagnostic examination
Official statutory text
A. For the purposes of this section:
1. "Breast magnetic resonance imaging" means a diagnostic tool
used to produce detailed pictures of the structure of the breast;
2. "Breast ultrasound" means a noninvasive, diagnostic imaging
technique that uses high-frequency sound waves to produce detailed
images of the breast;
3. "Diagnostic examination for breast cancer" means a medically
necessary and clinically appropriate examination, as defined by
current guidelines and as determined by a clinician who is
evaluating the individual for breast cancer, to evaluate the
abnormality in the breast that is:
a. seen or suspected from a screening examination for
breast cancer,
b. detected by another means of examination, or
c. suspected based on the medical history or family
medical history of the individual.
This examination may include, but is not limited to, a contrast–
enhanced mammogram, diagnostic mammogram, breast magnetic resonance
imaging, a breast ultrasound, or molecular breast imaging;
4. "Diagnostic mammography" means a diagnostic tool that:
a. uses X-ray, and
b. is designed to evaluate abnormality in a breast;
5. "Health benefit plan" means any plan or arrangement as
defined in subsection C of Section 6060.4 of this title;
6. "Low-dose mammography" means:
a. the X-ray examination of the breast using equipment
specifically dedicated for such purpose, with an
average radiation exposure delivery of less than one
rad mid-breast and with two views for each breast,
b. digital mammography, or
c. breast tomosynthesis;
7. "Breast tomosynthesis" means a radiologic mammography
procedure involving the acquisition of projection images over a
Oklahoma Statutes - Title 36. Insurance Page 1083
stationary breast to produce cross-sectional digital three-
dimensional images of the breast from which breast cancer screening
diagnoses may be made;
8. "Screening mammography" means a radiologic procedure
provided to a woman, who has no signs or symptoms of breast cancer,
for the purpose of early detection of breast cancer, including
breast tomosynthesis; and
9. "Supplemental examination" means a medically necessary and
appropriate examination of the breast, including, but not limited
to, such an examination using contrast–enhanced mammography, breast
magnetic resonance imaging, breast ultrasound, or molecular breast
imaging that is:
a. used to screen for breast cancer when there is no
abnormality seen or suspected, and
b. based on personal or family medical history or
additional factors that increase the individual's risk
of breast cancer, including heterogeneously or
extremely dense breasts.
B. All health benefit plans shall include the coverage
specified by this section for a low-dose mammography screening for
the presence of occult breast cancer and a diagnostic and
supplemental examination for breast cancer. Such coverage shall
not:
1. Be subject to the policy deductible, co-payments and co-
insurance limits of the plan; or
2. Require that a female undergo a mammography screening at a
specified time as a condition of payment.
C. 1. Any female thirty-five (35) through thirty-nine (39)
years of age shall be entitled pursuant to the provisions of this
section to coverage for a low-dose mammography screening once every
five (5) years.
2. Any female forty (40) years of age or older shall be
entitled pursuant to the provisions of this section to coverage for
an annual low-dose mammography screening.
D. If application of this act would result in health savings
account ineligibility under Section 223 of the federal Internal
Revenue Code, as amended, the provisions of this section shall only
apply to health savings accounts with qualified high deductible
health plans with respect to the deductible of such a plan after the
enrollee has satisfied the minimum deductible. Provided, however,
the provisions of this section shall apply to items of services that
unt ineligibility under Section 223 of the federal Internal
Revenue Code, as amended, the provisions of this section shall only
apply to health savings accounts with qualified high deductible
health plans with respect to the deductible of such a plan after the
enrollee has satisfied the minimum deductible. Provided, however,
the provisions of this section shall apply to items of services that
are preventive care pursuant to Section 223(c)(2)(c) of the federal
Internal Revenue Code, as amended, regardless of whether the minimum
deductible has been satisfied.
1. "Breast magnetic resonance imaging" means a diagnostic tool
used to produce detailed pictures of the structure of the breast;
2. "Breast ultrasound" means a noninvasive, diagnostic imaging
technique that uses high-frequency sound waves to produce detailed
images of the breast;
3. "Diagnostic examination for breast cancer" means a medically
necessary and clinically appropriate examination, as defined by
current guidelines and as determined by a clinician who is
evaluating the individual for breast cancer, to evaluate the
abnormality in the breast that is:
a. seen or suspected from a screening examination for
breast cancer,
b. detected by another means of examination, or
c. suspected based on the medical history or family
medical history of the individual.
This examination may include, but is not limited to, a contrast–
enhanced mammogram, diagnostic mammogram, breast magnetic resonance
imaging, a breast ultrasound, or molecular breast imaging;
4. "Diagnostic mammography" means a diagnostic tool that:
a. uses X-ray, and
b. is designed to evaluate abnormality in a breast;
5. "Health benefit plan" means any plan or arrangement as
defined in subsection C of Section 6060.4 of this title;
6. "Low-dose mammography" means:
a. the X-ray examination of the breast using equipment
specifically dedicated for such purpose, with an
average radiation exposure delivery of less than one
rad mid-breast and with two views for each breast,
b. digital mammography, or
c. breast tomosynthesis;
7. "Breast tomosynthesis" means a radiologic mammography
procedure involving the acquisition of projection images over a
Oklahoma Statutes - Title 36. Insurance Page 1083
stationary breast to produce cross-sectional digital three-
dimensional images of the breast from which breast cancer screening
diagnoses may be made;
8. "Screening mammography" means a radiologic procedure
provided to a woman, who has no signs or symptoms of breast cancer,
for the purpose of early detection of breast cancer, including
breast tomosynthesis; and
9. "Supplemental examination" means a medically necessary and
appropriate examination of the breast, including, but not limited
to, such an examination using contrast–enhanced mammography, breast
magnetic resonance imaging, breast ultrasound, or molecular breast
imaging that is:
a. used to screen for breast cancer when there is no
abnormality seen or suspected, and
b. based on personal or family medical history or
additional factors that increase the individual's risk
of breast cancer, including heterogeneously or
extremely dense breasts.
B. All health benefit plans shall include the coverage
specified by this section for a low-dose mammography screening for
the presence of occult breast cancer and a diagnostic and
supplemental examination for breast cancer. Such coverage shall
not:
1. Be subject to the policy deductible, co-payments and co-
insurance limits of the plan; or
2. Require that a female undergo a mammography screening at a
specified time as a condition of payment.
C. 1. Any female thirty-five (35) through thirty-nine (39)
years of age shall be entitled pursuant to the provisions of this
section to coverage for a low-dose mammography screening once every
five (5) years.
2. Any female forty (40) years of age or older shall be
entitled pursuant to the provisions of this section to coverage for
an annual low-dose mammography screening.
D. If application of this act would result in health savings
account ineligibility under Section 223 of the federal Internal
Revenue Code, as amended, the provisions of this section shall only
apply to health savings accounts with qualified high deductible
health plans with respect to the deductible of such a plan after the
enrollee has satisfied the minimum deductible. Provided, however,
the provisions of this section shall apply to items of services that
unt ineligibility under Section 223 of the federal Internal
Revenue Code, as amended, the provisions of this section shall only
apply to health savings accounts with qualified high deductible
health plans with respect to the deductible of such a plan after the
enrollee has satisfied the minimum deductible. Provided, however,
the provisions of this section shall apply to items of services that
are preventive care pursuant to Section 223(c)(2)(c) of the federal
Internal Revenue Code, as amended, regardless of whether the minimum
deductible has been satisfied.
Status: in_force · Read it on the official government site
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