Definitions

1. Law
2. Arkansas Code
3. Public Utilities and Regulated Industries
4. Insurance
5. Insurance Policies Generally
6. Coverage for Colorectal Cancer Screening
7. Definitions

As used in this subchapter:

1. (1) “Covered person” means a person who is and continues to remain eligible for coverage under a healthcare policy and is covered under a healthcare policy;

2. (2)

   1. (A) “Healthcare policy” means:

      1. (i) An individual or group health insurance policy providing coverage on an expense-incurred basis;

      2. (ii) An individual or group service or indemnity type contract issued by a nonprofit corporation;

      3. (iii) An individual or group service contract issued by a health maintenance organization;

      4. (iv) A group accident and sickness insurance policy issued by a fraternal benefit society, a nonprofit hospital service corporation, a nonprofit medical service corporation, a group healthcare plan, a health maintenance organization, or any similar entity; and

      5. (v) A policy issued by or in connection with:

         1. (a) The Arkansas medical assistance program and its contracted insurers, whether providing services on a managed-care or fee-for-service basis;

         2. (b) The state employees' and public school teachers' health insurance programs;

         3. (c) A self-insured group arrangement to the extent not preempted by federal law; and

         4. (d) A managed healthcare delivery entity of any type or description.

   2. (B) “Healthcare policy” does not include an accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, disability income, or other limited benefit health insurance policy; and

3. (3) “Persons at high risk for colorectal cancer” means:

   1. (A) Individuals over fifty (50) years of age or who face a high risk for colorectal cancer because of:

      1. (i) The presence of polyps on a previous colonoscopy, barium enema, or flexible sigmoidoscopy;

      2. (ii) A family history of colorectal cancer in close relatives of parents, brothers, sisters, or children;

      3. (iii) Genetic alterations of hereditary nonpolyposis colon cancer or familial adenomatous polyposis;

      4. (iv) A personal history of colorectal cancer, ulcerative colitis, or Crohn's disease; or

      5. (v) The presence of any appropriate recognized gene markers for colorectal cancer or other predisposing factors; and

   2. (B) Any additional or expanded definition of “persons at high risk for colorectal cancer” as recognized by medical science and determined by the Secretary of the Department of Health in consultation with the University of Arkansas for Medical Sciences.

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