(a) In this section, “orthopedic brace” means a rigid or semi–rigid device that is used to: (1) support a weak or deformed body member; or (2) restrict or eliminate motion in a diseased or injured part of the body. (b) Each health insurance contract that is delivered or issued for delivery in the State by a nonprofit health service […]
(a) This section applies to each policy or contract that is issued or delivered in the State to an employer or individual by an insurer or nonprofit health service plan. (b) (1) A policy or contract subject to this section that provides coverage on a group or individual basis for a diagnostic or surgical procedure involving a bone […]
(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) “Bone mass measurement” means a radiologic or radioisotopic procedure or other scientifically proven technology performed on a qualified individual for the purpose of identifying bone mass or detecting bone loss. (3) “Qualified individual” means: (i) an estrogen deficient individual at clinical risk for osteoporosis; (ii) an individual with […]
(a) (1) In this section the following words have the meanings indicated. (2) “Authorized prescriber” has the meaning stated in § 12-101 of the Health Occupations Article. (3) “Maintenance drug” means a drug anticipated to be required for 6 months or more to treat a chronic condition. (b) This section applies to: (1) insurers and nonprofit health service plans that provide […]
(a) This section applies to: (1) insurers and nonprofit health service plans that provide inpatient hospital, medical, or surgical benefits to individuals or groups on an expense–incurred basis under health insurance policies or contracts that are issued or delivered in the State; and (2) health maintenance organizations that provide inpatient hospital, medical, or surgical benefits to individuals or […]
(a) This section applies to: (1) insurers and nonprofit health service plans that provide coverage for prescription drugs under health insurance policies or contracts that are issued or delivered in the State; and (2) health maintenance organizations that provide coverage for prescription drugs under contracts that are issued or delivered in the State. (b) An entity subject to this […]
(a) In this section, “authorized prescriber” has the meaning stated in § 12–101 of the Health Occupations Article. (b) This section applies to: (1) insurers and nonprofit health service plans that provide coverage for contraceptive drugs and devices under individual, group, or blanket health insurance policies or contracts that are issued or delivered in the State; and (2) health […]
(a) (1) In this subsection, “group” means a group that is not a group covered under a health insurance policy or contract or under a health maintenance organization contract issued or delivered to a small employer, as defined in § 31–101 of this article. (2) This subsection applies to: (i) insurers and nonprofit health service plans that provide hospital, […]
(a) In this section, “fertility awareness–based methods” means methods of identifying times of fertility and infertility by an individual to avoid pregnancy, including: (1) cervical mucus methods; (2) sympto–thermal or sympto–hormonal methods; (3) the standard days method; and (4) the lactational amenorrhea method. (b) This section applies to: (1) insurers and nonprofit health service plans that provide hospital, medical, or surgical benefits […]
(a) (1) In this section the following words have the meanings indicated. (2) (i) “Cooperative group” means a formal network of facilities that collaborate on research projects and have an established NIH-approved Peer Review Program operating within the group. (ii) “Cooperative group” includes: 1. the National Cancer Institute Clinical Cooperative Group; 2. the National Cancer Institute Community Clinical Oncology Program; 3. the AIDS […]
(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) “Chlamydia screening test” means any laboratory test that: (i) specifically detects for infection by one or more agents of chlamydia trachomatis; and (ii) is approved for this purpose by the federal Food and Drug Administration. (3) “Human papillomavirus screening test” means any laboratory test that: (i) specifically detects for […]
(a) (1) In this section the following words have the meanings indicated. (2) “Carrier” means: (i) an insurer that offers health insurance other than long–term care insurance or disability insurance; (ii) a nonprofit health service plan; (iii) a health maintenance organization; (iv) a dental plan organization; or (v) except for a managed care organization as defined in Title 15, Subtitle 1 of the […]
(a) (1) In this section the following words have the meanings indicated. (2) “Authorized prescriber” has the meaning stated in § 12–101 of the Health Occupations Article. (3) “Formulary” means a list of prescription drugs or devices that are covered by an entity subject to this section. (4) (i) “Member” means an individual entitled to health care benefits for prescription drugs […]
(a) This section applies to: (1) insurers and nonprofit health service plans that provide inpatient hospital, medical, or surgical benefits to individuals or groups on an expense–incurred basis under health insurance policies or contracts that are issued or delivered in the State; and (2) health maintenance organizations that provide inpatient hospital, medical, or surgical benefits to individuals or […]
(a) In this section, “mastectomy” means the surgical removal of all or part of a breast as a result of breast cancer. (b) This section applies to: (1) insurers and nonprofit health service plans that provide inpatient hospital, medical, or surgical benefits to individuals or groups on an expense–incurred basis under health insurance policies or contracts that are […]
(a) A policy will be considered to provide benefits on an expense-incurred basis if benefits payable under the policy are based on both medical expenses incurred and flat fees regardless of actual expenses incurred. (b) This section applies to health benefit plans issued under Subtitle 12 of this title. (c) This section does not apply if: (1) coverage is […]
(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 or contracts 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 […]
(a) (1) In this section the following words have the meanings indicated. (2) “Habilitative services” means services and devices, including occupational therapy, physical therapy, and speech therapy, that help a child keep, learn, or improve skills and functioning for daily living. (3) “Managed care system” means a method that an insurer, a nonprofit health service plan, or a health […]
