(a) “Diagnostic breast examination” means an examination used to evaluate an abnormality of the breast that is detected or suspected from a screening examination for breast cancer or by any other means of examination using:
(A) Diagnostic mammography;
(B) Breast magnetic resonance imaging; or
(C) Breast ultrasound.
(b) “Supplemental breast examination” means an examination of the breast, such as breast magnetic resonance imaging or breast ultrasound, 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 other factors that increase an individual’s risk of breast cancer.
(2) Except as provided in ORS 742.008, a carrier offering a group health benefit plan or an individual health benefit plan in this state that reimburses the cost of supplemental or diagnostic breast examinations may not impose on the coverage of a medically necessary supplemental or diagnostic breast examination:
(a) A deductible;
(b) Coinsurance;
(c) A copayment; or
(d) Other out-of-pocket expenses. [2023 c.468 §2]
Note: See 743A.001.
Note: Definitions for 743A.101 may be found in 743B.005.
Note: 743A.101 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743A or any series therein. See Preface to Oregon Revised Statutes for further explanation.