(a) This section applies to: (1) insurers that propose to issue or deliver in the State group or blanket health insurance policies that are written on an expense-incurred basis; and (2) nonprofit health service plans that propose to issue or deliver in the State group medical or major medical contracts that are written on an expense-incurred basis. (b) An […]
(a) (1) In this section the following words have the meanings indicated. (2) “Alcohol misuse” has the meaning stated in § 8–101 of the Health – General Article. (3) “ASAM criteria” means the most recent edition of the American Society of Addiction Medicine treatment criteria for addictive, substance–related, and co–occurring conditions that establishes guidelines for placement, continued stay and […]
(a) An insurer or nonprofit health service plan that issues or delivers an individual, group, or blanket health insurance policy or contract in the State, or a health maintenance organization that issues or delivers an individual or group contract in the State, may not exclude payments for blood products, both derivatives and components, that otherwise would […]
(a) (1) In this section the following words have the meanings indicated. (2) “Medical literature” means scientific studies published in a peer–reviewed national professional medical journal. (3) “Off–label use” means the prescription of a drug for a treatment other than those treatments stated in the labeling approved by the federal Food and Drug Administration. (4) “Standard reference compendia” means any […]
(a) (1) In this section the following words have the meanings indicated. (2) “Authorized prescriber” means a licensed dentist, licensed physician, or licensed podiatrist who is authorized under the Health Occupations Article to prescribe a pharmaceutical product. (3) “Pharmaceutical product” means a drug or medicine that may be prescribed by an authorized prescriber. (b) This section does not apply to […]
A nonprofit health service plan that provides pharmaceutical services shall allow a subscriber, member, or beneficiary to fill prescriptions at the pharmacy of the subscriber’s, member’s, or beneficiary’s choice.
(a) (1) In this section the following words have the meanings indicated. (2) (i) “Inherited metabolic disease” means a disease caused by an inherited abnormality of body chemistry. (ii) “Inherited metabolic disease” includes a disease for which the State screens newborn babies. (3) (i) “Low protein modified food product” means a food product that is: 1. specially formulated to have less than 1 […]
(a) In this section, “home health care” means the continued care and treatment of a covered individual if: (1) institutionalization of the individual would have been required if home health care was not provided; and (2) the individual’s physician establishes and approves in writing the plan of treatment covering the home health care service. (b) This section applies to […]
(a) (1) Each insurer that issues or delivers individual health insurance policies in the State that are written on an expense-incurred basis shall offer benefits for hospice care services to its insureds. (2) Each insurer that issues or delivers group or blanket health insurance policies or contracts in the State that are written on an expense-incurred basis shall […]
(a) This section applies to: (1) insurers and nonprofit health service plans that provide hospital, medical, or surgical benefits to individuals or groups on an expense–incurred basis under health insurance policies that are issued or delivered in the State; and (2) health maintenance organizations that provide hospital, medical, or surgical benefits to individuals or groups under contracts that […]
(a) (1) In this section the following words have the meanings indicated. (2) “Iatrogenic infertility” means an impairment of fertility caused directly or indirectly by surgery, chemotherapy, radiation, or other medical treatment affecting the reproductive organs or processes. (3) “Medical treatment that may directly or indirectly cause iatrogenic infertility” means medical treatment with a likely side effect of infertility […]
(a) Each insurer and nonprofit health service plan that issues or delivers an individual, group, or blanket health insurance policy in the State that provides hospitalization benefits for normal pregnancy shall provide hospitalization benefits for childbirth to the same extent as the hospitalization benefits provided in the policy for any covered illness. (b) (1) In addition to the […]
(a) (1) In this section the following words have the meanings indicated. (2) “Attending provider” means an obstetrician, pediatrician, other physician, certified nurse midwife, or pediatric nurse practitioner attending a mother or newborn child. (3) “High-deductible health plan” means a health benefit plan that meets the federal requirements established by § 1201 of the Medicare Prescription Drug, Improvement, and […]
(a) This section applies to each group or blanket health insurance policy that: (1) is issued or delivered in the State; (2) is issued or delivered to an entity that is incorporated or has a main office in the State; or (3) covers individuals who reside or work in the State. (b) Each insurer that proposes to issue a policy […]
(a) In this section, “digital tomosynthesis” means a radiologic procedure that involves the acquisition of projection images over the stationary breast to produce cross–sectional digital three–dimensional images of the breast. (b) This section applies to: (1) insurers and nonprofit health service plans that provide hospital, medical, or surgical benefits to individuals or groups on an expense–incurred basis under […]
(a) (1) In this section the following words have the meanings indicated. (2) “Mastectomy” means the surgical removal of all or part of a breast. (3) (i) “Reconstructive breast surgery” means surgery performed as a result of a mastectomy to reestablish symmetry between the two breasts. (ii) “Reconstructive breast surgery” includes augmentation mammoplasty, reduction mammoplasty, and mastopexy. (b) This section applies to […]
(a) This section applies to: (1) insurers and nonprofit health service plans that provide hospital, medical, or surgical benefits to individuals or groups on an expense-incurred basis under health insurance policies that are issued or delivered in the State; and (2) health maintenance organizations that provide hospital, medical, or surgical benefits to individuals or groups under contracts that […]
(a) In this section, “child wellness services” means preventive activities designed to protect children from morbidity and mortality and promote child development. (b) This section applies to each individual hospital or major medical insurance policy, group or blanket health insurance policy, and nonprofit health service plan that: (1) is delivered or issued for delivery in the State; (2) is […]
(a) This section applies to: (1) each individual or group hospital or major medical insurance policy or certificate that is delivered or issued for delivery in the State by an insurer and is written on an expense–incurred basis; (2) each individual or group medical or major medical contract, policy, or certificate that is delivered or issued for delivery […]
(a) This section applies to: (1) each individual, group, or blanket health insurance policy that is issued or delivered in the State by an insurer; and (2) each contract or certificate that is issued or delivered in the State by a nonprofit health service plan. (b) A policy, contract, or certificate subject to this section that provides coverage for […]
