Mandated Benefit Statute History Short-Term Individual and Group/Blanket Major Medical Large Group/Blanket Major Medical EHB for Individual and Small Group Major Medical
Autism Spectrum Disorders 23-99-418 2011, HB 1315, s 1, eff. 10-1-2011. Group/Blanket Only Group/Blanket Only Yes
Breast Reconstruction/Mastectomy 23-99-405 Acts 1997, No. 1196, § 5;  2003, No. 179 (HB 1280), § 1, eff. 7-16-2003. Yes, if plan provides mastectomy benefits Yes, if plan provides mastectomy benefits Yes
Children’s Preventative Healthcare 23-79-141; Rule 45 Acts 1989, No. 860, § 1; 1995, No. 685, § 1; 2001, No. 1604, §§ 105 — 107, eff. 8-12-2001; 2011, HB 1806, s 14, eff. 7-27-2011. Yes, if family coverage provided Yes, if family coverage provided Yes
Colorectal Cancer Screening 23-79-1201, et seq. Acts 2005, No. 2236 (HB 2781), § 2, eff. 8-1-2005. Group Only Group Only Yes
Dental Anesthesia 23-86-121 Acts 2005, No. 439 (HB 1452), § 1;  2005, No. 2221 (HB 2640), §§ 1, 2, eff. 8-12-2005. No Yes Yes
Diabetic Supplies/Education 23-79-601, et seq. & Rule 70; 23-79-607 Acts 1997, No. 1249, § 1, eff. 7-31-97. Group/Individual Only (N/A to individual, non-renewable STLDI that expires after 6 months) Yes Yes
Medical Foods and Low Protein Modified Food Products 23-79-701, et seq. Acts 1999, No. 1113, § 3; 2001, No. 1603, § 38; 2001, No. 1654, § 1; 2003, No. 1440 (SB 609), § 2, eff. 7-16-2003; 2017, HB 1900, s 1, eff. 90 days after legislature adjourns. Yes Yes Yes
Gastric Pacemakers 23-99-419 2011, HB 1915, s 1, eff. 7-27-2011. Yes Yes Yes
In Vitro Fertilization 23-85-137; 23-86-118; Rule 1  Acts 1987, No. 779, § 1; 1991, No. 920, § 1; 2001, No. 909, § 12, eff. 8-12-2001; 2011, SB 213, s 1, eff. 7-27-2011.; Acts 1987, No. 779, § 1;  1991, No. 920, § 2; 2001, No. 1063, § 18, eff. 8-12-2001. Yes, if maternity benefits provided (N/A HMOs) Yes, if maternity benefits provided (N/A HMOs) No, but must be covered by all insurance companies (N/A HMOs)
Loss or Impairment of Speech or Hearing 23-79-130 Acts 1985, No. 303, §§ 1, 4;  A.S.A. 1947, §§ 66-3260, 66-3263;  Acts 2005, No. 1995 (SB 998), § 2, eff. 4-11-2005. Yes Yes Yes
Hospital Stay for Childbirth and Newborns 23-99-404  Acts 1997, No. 1196, § 4, eff. 7-31-97. Yes, if maternity benefits provided Yes, if maternity benefits provided Yes
Newborn Infant Coverage 23-79-129 Acts 1975, No. 298, §§ 1 — 3;  1981, No. 481, § 3; 1983, No. 357, § 1; 1983, No. 522, § 27; A.S.A. 1947, §§ 66-3248 — 66-3250; Acts 1987, No. 456, § 15; 1987, No. 573, § 3; 1987 (1st Ex. Sess.), No. 12, § 1; 1987 (1st Ex. Sess.), No. 60, § 1; 1995, No. 113, § 2; 2001, No. 1604, § 99; 2003, No. 1293 (SB 610), § 3, eff. 7-16-2003; 2013, SB 423, s 2, eff. 8-16-2013. Yes, if family coverage provided Yes, if family coverage provided Yes
Mental Health Parity 23-99-501, et seq. Acts 1997, No. 1020, § 1, eff. 7-31-97; 2009, HB 2195, s 1, eff. 7-31-2009. Group/Blanket Only, if mental health covered Yes, if mental health covered Yes
Off-Label Drug Use 23-79-147 Acts 1995, No. 1231, §§ 1, 2;  1999, No. 466, § 1, eff. 7-30-99; 2009, HB 1363, s 1, eff. 7-31-2009. Yes, if prescriptions covered Yes, if prescriptions covered Yes
Prostate Cancer Screening 23-79-1301, et seq. 2009, HB 1031, s 1, eff. 7-31-2009. Yes Yes Yes
Orthotic & Prosthetic Devices or Services 23-99-417; Rule 109 2009, HB 2244, s 2, eff. 7-31-2009; 2013, SB 455, ss 1, 2, eff. 8-16-2013. Yes Yes Yes
Craniofacial 23-79-1501, et seq.; Rule 111 2013, HB 2121, s 1, eff. 8-16-2013; 2015, HB 1417, s 1, eff. 7-22-2015. Yes Yes Yes
Telemedicine 23-79-1601, et seq. 2015, SB 133, s 4, eff. 4-1-2015; 2017, SB 146, s 4, eff. 1-1-2018. Yes Yes Yes
Equity in Prescription Contraceptive 23-79-1101, et seq. Acts 2005, No. 2217 (HB 2618), § 1, eff. 8-12-2005. Yes, if prescriptions covered Yes, if prescriptions covered Yes
Oral and Intravenously Anticancer Medication Parity 23-79-161 2017, HB 1592, s 1, eff. 1-1-2018. Group/Blanket Only, if injected or IV cancer medications covered Yes, if injected or IV cancer medications covered Yes
           
Mandated Offering Statute History Short-Term Individual and Group/Blanket   EHB for Individual and Small Group
TMJ - Musculoskeletal Disorders of the Face, Neck, or Head 23-79-150 Acts 2001, No. 1470, §§ 1, 2, eff. 8-12-2001. Yes Yes Yes
Benefits for Treatment of Alcohol and Drug Dependency 23-79-139 Acts 1987, No. 1047, §§ 1 — 6; 2001, No. 1604, § 103, eff. 8-12-2001; 2013, HB 1499, s 43, eff. 8-16-2013; 2017, HB 1289, s 118, eff. 90 days after legislature adjourns. Group Only Group Only Yes
Hospice 23-86-120 Acts 1999, No. 922, § 1;  2001, No. 1063, § 20, eff. 8-12-2001. No Yes Yes
Minimum Benefits for Mental Disorders 23-86-113 Acts 1983, No. 326, §§ 1 — 5; 1985, No. 236, § 1; A.S.A. 1947, §§ 66-3716 — 66-3720; Acts 1995, No. 1272, § 21; 2001, No. 1063, § 13, eff. 8-12-2001; 2013, HB 1497, s 17, eff. 8-16-2013; 2017, HB 1289, s 119, eff. 90 days after legislature adjourns. Group Only, if hospitalizaion or medical benefits for mental illness provided Group Only, if hospitalizaion or medical benefits for mental illness provided Yes
Mammograms/Breast Ultrasounds 23-79-140 (Cannot be subject to deductible.)  Acts 1989, No. 292, §§ 2 — 4, 6; 1995, No. 508, § 2; 2001, No. 1604, § 104, eff. 8-12-2001; 2013, SB 888, s 2, eff. 8-16-2013; 2017, HB 1724, s 2, eff. 3-15-2017; 2017, HB 2022, ss 1 — 5, eff. 90 days after legislature adjourns. No No Yes
Certain Inpatient Services Must Also be  Provided as Out-patient Services:  Laboratory and pathological tests, X-rays, Chemotherapy, Radiation treatment, Renal dialysis 23-86-108(5) Acts 1959, No. 148, § 420;  1967, No. 418, § 3; 1969, No. 263, § 3; 1975, No. 404, §§ 2, 8; 1975, No. 649, §§ 2, 8; 1981, No. 810, § 1; 1983, No. 522, §§ 31, 32; A.S.A. 1947, § 66-3702; Acts 1987, No. 456, § 17; 1987, No. 478, § 1; 1997, No. 208, § 28; 2001, No. 1063, § 8, eff. 8-12-2001. Group Only Yes Yes
Psychological Examiners 23-79-142 Acts 1991, No. 624, § 1;  2001, No. 1604, § 108, eff. 8-12-2001. Group Only, if mental health coverage provided Group Only, if mental health coverage provided Yes
Hearing Aid 23-79-1402; 7A-2009 (Cannot be subject to deductible or copay) 2009, HB 1930, s 1, eff. 7-31-2009. Yes (N/A HMOs) Yes (N/A HMOs) Yes