Surveillance Tests for Ovarian Cancer

  1. Law
  2. Georgia Code
  3. Insurance
  4. Insurance Generally
  5. General Provisions
  6. Surveillance Tests for Ovarian Cancer

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  1. As used in this Code section, the term:
    1. "At risk for ovarian cancer" means:
      1. Having a family history:
        1. With one or more first or second-degree relatives with ovarian cancer;
        2. Of clusters of women relatives with breast cancer;
        3. Of nonpolyposis colorectal cancer; or
      2. Testing positive for BRCA1 or BRCA2 mutations.
    2. "Health benefit policy" means any individual or group plan, policy, or contract for health care services issued, delivered, issued for delivery, executed, or renewed in this state, including, but not limited to, those contracts executed by the state on behalf of state employees under Article 1 of Chapter 18 of Title 45, by an insurer.
    3. "Insurer" means an accident and sickness insurer, fraternal benefit society, health care corporation, health maintenance organization, preferred provider organization, provider sponsored health care corporation, managed care entity, or any similar entity authorized to issue contracts under this title or to provide health benefit policies.
    4. "Surveillance tests" means annual screening using:
      1. CA-125 serum tumor marker testing;
      2. Transvaginal ultrasound; and
      3. Pelvic examination.
  2. Every health benefit policy that is delivered, issued, issued for delivery, executed, or renewed in this state or approved for issuance or renewal in this state by the Commissioner shall provide coverage for surveillance tests for women age 35 and over at risk for ovarian cancer.
  3. The benefits provided in this Code section shall be subject to the same annual deductibles or coinsurance established for all other covered benefits within a given health benefit policy.
  4. A physician who assesses a patient for ovarian cancer and such patient is at risk for ovarian cancer is encouraged to advise such patient of the availability of surveillance tests in accordance with the practices of the profession generally under similar conditions and like surrounding circumstances.

(Code 1981, §33-24-56.2, enacted by Ga. L. 2001, p. 91, § 1; Ga. L. 2019, p. 386, § 54/SB 133.)

The 2019 amendment, effective July 1, 2019, substituted "including, but not limited to, those contracts executed by the state" for "including but not limited to those contracts executed by the State of Georgia" in paragraph (a)(2); deleted "hospital service corporation, medical service corporation," following "fraternal benefit society" near the middle of paragraph (a)(3); and deleted "on or after July 1, 2001," following "Commissioner" in the middle of subsection (b).


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