Section 15-814 – Coverage for Breast Cancer Screenings
(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 […]
Section 15-827 – Coverage for Patient Cost for Clinical Trials
(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 […]
Section 15-815 – Coverage for Reconstructive Breast Surgery
(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 […]
Section 15-816 – Benefits for Routine Gynecological Care
(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 […]
Section 15-817 – Coverage for Child Wellness Services
(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 […]
Section 15-818 – Benefits for Treatment of Cleft Lip and Cleft Palate
(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 […]
Section 15-819 – Coverage for Outpatient Services and Second Opinions
(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 […]
Section 15-820 – Benefits for Orthopedic Braces
(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 […]
Section 15-821 – Diagnostic and Surgical Procedures for Bones of Face, Neck, and Head
(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 […]
Section 15-822 – Coverage for Diabetes Equipment, Supplies, and Self-Management Training
(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 […]