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 […]
Section 15-808 – Benefits for Home Health Care
(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 […]
Section 15-809 – Benefits for Hospice Care Services
(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 […]
Section 15-810 – Benefits for in Vitro Fertilization
(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 15-810.1 – Coverage for Standard Fertility Preservation Procedures
(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 […]
Section 15-801 – Benefits for Alzheimer’s Disease and Care of Elderly Individuals
(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 […]
Section 15-802 – Benefits for Treatment of Mental Illnesses, Emotional Disorders, and Drug and Alcohol Misuse
(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 […]
Section 15-803 – Payments for Blood Products
(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 […]
Section 15-804 – Coverage for Off-Label Use of Drugs
(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 […]
Section 15-805 – Reimbursement for Pharmaceutical Products
(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 […]