§431:10A-115.5 Coverage for child health supervision services. (a) All health insurance policies issued in this State which provide coverage for the children of the insured shall provide coverage for child health supervision services from the moment of birth through age five years. These services shall be exempt from any deductible provisions, and immunizations shall be exempt from any copayment provisions, which may be in force in these policies or contracts.
(b) Child health supervision services shall include twelve visits at approximately the following intervals: birth; two months; four months; six months; nine months; twelve months; fifteen months; eighteen months; two years; three years; four years; and five years. Services to be covered at each visit shall include a history, physical examination, developmental assessment, anticipatory guidance, immunizations, and laboratory tests, in keeping with prevailing medical standards. For purposes of this subsection, the term "prevailing medical standards" means the recommendations of the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services and the American Academy of Pediatrics; provided that if the recommendations of the committee and the academy differ, the department of health shall determine which recommendations shall apply.
(c) Minimum benefits may be limited to one visit payable to one provider for all of the services provided at each visit cited in this section, except that the limitations authorized by this subsection shall not apply to immunizations recommended by the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services and the American Academy of Pediatrics; provided that if the recommendations of the committee and the academy differ, the department of health shall determine which recommendations shall apply.
(d) This section does not apply to disability income, specified disease, medicare supplement, or hospital indemnity policies.
(e) For the purposes of this section, "child health supervision services" means physician-delivered, physician-supervised, physician assistant-delivered, or nurse-delivered services as defined by section 457-2 ("registered nurse") which shall include as the minimum benefit coverage for services delivered at intervals and scope stated in this section. [L 1988, c 201, §1; am L 1993, c 83, §1 and c 362, §3; am L 2009, c 151, §18; am L 2020, c 70, §54]
In subsection (c), "that" deleted after "provided that if" pursuant to §23G-15.