WAC "Life threatening condition" means any disease or condition (4)(e) from which the likelihood of death is probable unless the course of the disease or condition is interrupted. Clinical Trials Requirements (Cont’d) for coverage (Cont’d) Colorectal Requirement Plan must provide coverage for colorectal cancer exams and lab Cancer for Coverage RCW tests consistent with the A and B recommendations of the USPSTF Screening 48.43.043(1) or the CDC. Coverage must be provided: RCW For any of the colorectal screening exams and tests in the 48.43.043(1)(a) selected recommendations, at a frequency identified therein, as deemed appropriate by the patient's physician after consultation with the patient; and To an enrollee who is: (1)(b)(i) At fifty years old; or RCW 48.43.043 Less than fifty years old and at high risk or very high risk for (1)(b)(ii) colorectal cancer according to such guidelines or recommendations. Colorectal Burdensome RCW Plan design must not require patients and providers to meet Cancer Requirements 48.43.043(2) burdensome criteria or overcome significant obstacles to secure Screening Prohibited such coverage. Enrollee may not be required to pay an (Cont’d) additional deductible or coinsurance for testing greater than a deductible or coinsurance for similar benefits. If the plan does not cover a similar benefit, a deductible or coinsurance may not
Clinical Trials (Cont’d) Requirements for coverage (Cont’d) WAC (4)(e) "Life threatening condition" means any disease or condition from which the likelihood of death is probable unless the course of the disease or condition is interrupted. Colorectal Cancer Screening Colorectal Cancer Screening (Cont’d) Requirement for Coverage RCW 48.43.043(1) Plan must provide coverage for colorectal cancer exams and lab tests consistent with the A and B recommendations of the USPSTF or the CDC. Coverage must be provided: RCW 48.43.043(1)(a) (1)(b)(i) For any of the colorectal screening exams and tests in the selected recommendations, at a frequency identified therein, as deemed appropriate by the patient's physician after consultation with the patient; and To an enrollee who is: At fifty years old; or RCW 48.43.043 (1)(b)(ii) Less than fifty years old and at high risk or very high risk for colorectal cancer according to such guidelines or recommendations. Burdensome Requirements Prohibited RCW 48.43.043(2) Plan design must not require patients and providers to meet burdensome criteria or overcome significant obstacles to secure such coverage. Enrollee may not be required to pay an additional deductible or coinsurance for testing greater than a deductible or coinsurance for similar benefits. If the plan does not cover a similar benefit, a deductible or coinsurance may not
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