376.1275. Coverage for human leukocyte antigen testing for bone marrow transplantation required, when--exceptions. - Missouri Statutes

Coverage for human leukocyte antigen testing for bone marrowtransplantation required, when--exceptions.

376.1275. 1. Each health carrier or health benefit plan that offers orissues health benefit plans which are delivered, issued for delivery,continued, or renewed in this state on or after January 1, 2003, shall includecoverage for their members for the cost for human leukocyte antigen testing,also referred to as histocompatibility locus antigen testing, for A, B, and DRantigens for utilization in bone marrow transplantation. The testing must beperformed in a facility which is accredited by the American Association ofBlood Banks or its successors, and is licensed under the Clinical LaboratoryImprovement Act, 42 U.S.C. Section 263a, as amended, and is accredited by theAmerican Association of Blood Banks or its successors, the College of AmericanPathologists, the American Society for Histocompatibility and Immunogenetics(ASHI) or any other national accrediting body with requirements that aresubstantially equivalent to or more stringent than those of the College ofAmerican Pathologists. At the time of testing, the person being tested mustcomplete and sign an informed consent form which also authorizes the resultsof the test to be used for participation in the National Marrow Donor Program. The health benefit plan may limit each enrollee to one such testing perlifetime to be reimbursed at a cost of no greater than seventy-five dollars bythe health carrier or health benefit plan.

2. For the purposes of this section, "health carrier" and "healthbenefit plan" shall have the same meaning as defined in section 376.1350.

3. The health care service required by this section shall not be subjectto any greater deductible or co-payment than other similar health careservices provided by the health benefit plan.

4. The provisions of this section shall not apply to a supplementalinsurance policy, including a life care contract, accident-only policy,specified disease policy, hospital policy providing a fixed daily benefitonly, Medicare supplement policy, long-term care policy, short-term majormedical policies of six months' or less duration, or any other supplementalpolicy as determined by the director of the department of insurance, financialinstitutions and professional registration.

(L. 2002 S.B. 1026)