(b) A health insurance plan shall provide coverage for colorectal cancer screening, including:

1. (1) for a covered individual who is not at high risk for colorectal cancer, colorectal cancer screening examinations and laboratory tests in accordance with the most recently published recommendations established by the U.S. Preventive Services Task Force for average-risk individuals; and
2. (2) for a covered individual who is at high risk for colorectal cancer, colorectal cancer screening examinations and laboratory tests as recommended by the treating health care professional.

(c) For the purposes of subdivision (b)(2) of this section, an individual is at high risk for colorectal cancer if the individual has:

1. (1) a family medical history of colorectal cancer or a genetic syndrome predisposing the individual to colorectal cancer;
2. (2) a prior occurrence of colorectal cancer or precursor polyps;
3. (3) a prior occurrence of a chronic digestive disease condition such as inflammatory bowel disease, Crohn’s disease, or ulcerative colitis; or
4. (4) other predisposing factors as determined by the individual’s treating health care professional.

(d) Colorectal cancer screening services performed under contract with the insurer shall not be subject to any co-payment, deductible, coinsurance, or other cost-sharing requirement. In addition, a covered individual shall not be subject to any additional charge for any service associated with a procedure or test for colorectal cancer screening, which may include one or more of the following:

1. (1) removal of tissue or other matter;
2. (2) laboratory services;
3. (3) health care professional services;
4. (4) facility use; and
5. (5) anesthesia. (Recodified and amended 2025, No. 11, § 2, eff. September 1, 2025.)