§ 304-17a-259

304.17A -259 Coverage under health benefit plan for genetic test for cancer risk. (1) As used in this section, 'genetic test for cancer risk' means a blood, saliva, or tissue typing test that reliably determines the presence or absence of an inherited genetic characteristic that is generally accepted in the medical or scientific communi ty as being associated with a statistically significant increased risk of cancer development. (2) (a) All health benefit plans issued or renewed on or after January 1, 2020, shall cover any genetic test for cancer risk that is recommended by any of the following, if the recommendation is consistent with the most recent version of genetic testing guidelines published by the National Comprehensive Cancer Network (NCCN): 1. A physician, physician assistant, or genetic counselor licensed under KRS Chapter 311; or 2. An advanced practice registered nurse licensed under KRS Chapter 314. (b) The commissioner may extend the coverage required by paragraph (a) of this subsection to include recommendations that are consistent with the most recent version of genetic tes ting guidelines or criteria published by additional national medical societies, if the

a) of this subsection to include recommendations that are consistent with the most recent version of genetic tes ting guidelines or criteria published by additional national medical societies, if the guidelines or criteria are determined by the commissioner to be relevant and reliable. (3) Coverage required by this section shall: (a) Not be subject to a deductible, c oinsurance, or any other cost -sharing requirements; and (b) Include coverage at the health benefit plan's average in -network rate for out - of-network providers or laboratories if there are no in -network providers or laboratories available to provide the cov ered test. (4) This section shall not be construed to limit coverage required by KRS 304.17A -257 or any other law. Effective: January 1, 2020 History: Created 2019 Ky. Acts ch. 29, sec. 1, effective January 1, 2020.