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Rs 22:1055 Requirement For Coverage Of Diagnosis And Treatment For Temporomandibular Joint And Associated Musculature And Neurology

§1055. Requirement for coverage of diagnosis and treatment for temporomandibular joint

and associated musculature and neurology

A. Every hospital, health, or medical expense insurance policy in the large group

market as defined in R.S. 22:1091(B), delivered or issued for delivery in this state shall

include coverage for diagnostic, therapeutic, or surgical procedures related to the

temporomandibular joint (TMJ) and associated musculature and neurological conditions.

This Section shall not apply to coverage provided by the Office of Group Benefits.

B. The coverage for diagnostic, therapeutic, or surgical procedures related to

temporomandibular joint and associated musculature and neurological conditions shall be

subject to the same conditions, limitations, precertification, prior authorization, referral

procedures, copayment, and coinsurance provisions that apply to coverage for diagnostic,

therapeutic, or surgical procedures involving other bones or joints of the human skeleton.

C. The provisions of this Section shall apply to all new policies, plans, certificates,

and contracts issued on or after January 1, 2018. Existing policies, plans, certificates, and

contracts shall include the coverage required by this Section on renewal thereof, but in no

case later than January 1, 2019.

Acts 2016, No. 405, §1, eff. June 8, 2016.

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Local Government
Louisiana
5
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John Bel Edwards
John Bel Edwards
January 11, 2016 -
Democratic
1-225-342-4404
900 North 3rd Street, Baton Rouge, LA, 70802

Keywords
coverage
joint
temporomandibular
associated
musculature
procedures
surgical
treatment
requirement
neurology