reglab/housing_qa huggingface dataset:
MD. Insurance Code Ann. §  15-824 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-824 - Coverage for Maintenance Drugs

    (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 coverage for drugs under health insurance policies or contracts that are delivered or issued for delivery in the State to employers or individuals on a group or individual basis; and        (2)    health maintenance organizations that provide coverage for drugs under contracts that are delivered or issued for delivery in the State to employers or individuals on a group or individual basis.    (c)    This section does not apply to an insured or enrollee who is a resident of a nursing home.    (d)    (1)    An entity subject to this section shall allow an insured or enrollee, if authorized by an authorized prescriber, to receive up to a 90-day supply of a maintenance drug in a single dispensing of the prescription.        (2)    The provisions of paragraph (1) of this subsection do not apply to the first prescription or change in a prescription for a maintenance drug that the authorized prescriber prescribes for the insured or enrollee.    (e)    Whenever an entity subject to this section increases the co-payment for a single dispensing of a prescription in a supply in excess of 30 days, the entity shall also proportionately increase the dispensing fee to the pharmacist for the prescription.
MD. Insurance Code Ann. §  15-825 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-825 - Coverage for Detection of Prostate Cancer

    (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 groups under contracts that are issued or delivered in the State.    (b)    An entity subject to this section shall provide coverage for the expenses incurred in conducting a medically recognized diagnostic examination which shall include a digital rectal exam and a blood test called the prostate–specific antigen (PSA) test:        (1)    for men who are between 40 and 75 years of age;        (2)    when used for the purpose of guiding patient management in monitoring the response to prostate cancer treatment;        (3)    when used for staging in determining the need for a bone scan in patients with prostate cancer; or        (4)    when used for male patients who are at high risk for prostate cancer.    (c)    Subject to federal guidance on the preventive care safe harbor for the absence of a preventive care deductible provided for under 26 U.S.C. § 223(c)(2)(C), an entity subject to this section may not apply a deductible, a copayment, or coinsurance to coverage for preventive care screening services for prostate cancer, which shall include a digital rectal exam and a blood test called the prostate–specific antigen (PSA) test in accordance with subsection (b) of this section.
MD. Insurance Code Ann. §  15-826 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-826 - Coverage for Prescription Drugs

    (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 section:        (1)    shall provide coverage for any contraceptive drug or device that is approved by the United States Food and Drug Administration for use as a contraceptive and that is obtained under a prescription written by an authorized prescriber as defined in § 12-101 of the Health Occupations Article;        (2)    shall provide coverage for the insertion or removal, and any medically necessary examination associated with the use, of such contraceptive drug or device; and        (3)    may not impose a different copayment or coinsurance for a contraceptive drug or device than is imposed for any other prescription.    (c)    (1)    A religious organization may request and an entity subject to this section shall grant the request for an exclusion from coverage under the policy, plan, or contract for the coverage required under subsection (b) of this section if the required coverage conflicts with the religious organization’s bona fide religious beliefs and practices.        (2)    A religious organization that obtains an exclusion under paragraph (1) of this subsection shall provide its employees reasonable and timely notice of the exclusion.
MD. Insurance Code Ann. §  15-826.2 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-826.2 - Coverage for Male Sterilization

    (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, medical, or surgical benefits to groups on an expense–incurred basis under health insurance policies or contracts that are issued or delivered in the State; and            (ii)    health maintenance organizations that provide hospital, medical, or surgical benefits to groups under contracts that are issued or delivered in the State.        (3)    This subsection does not apply to an organization that requests and receives an exclusion from coverage under § 15–826(c) of this subtitle.        (4)    An entity subject to this subsection shall provide coverage for male sterilization.    (b)    (1)    This subsection applies to:            (i)    insurers and nonprofit health service plans that provide coverage for male sterilization under individual, group, or blanket health insurance policies or contracts that are issued or delivered in the State; and            (ii)    health maintenance organizations that provide coverage for male sterilization under individual or group contracts that are issued or delivered in the State.        (2)    Except with respect to a health benefit plan that is a grandfathered health plan, as defined in § 1251 of the Affordable Care Act, an entity subject to this subsection may not apply a copayment, coinsurance requirement, or deductible to coverage for male sterilization.
MD. Insurance Code Ann. §  15-826.3 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-826.3 - Coverage for Fertility Awareness-Based Methods

    (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 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 contracts that are issued or delivered in the State.    (c)    An entity subject to this section shall provide coverage for instruction by a licensed health care provider on fertility awareness–based methods.    (d)    Except with respect to a health benefit plan that is a grandfathered health plan, as defined in § 1251 of the Affordable Care Act, an entity subject to this section may not apply a copayment, coinsurance requirement, or deductible to the coverage required under this section.
MD. Insurance Code Ann. §  15-828 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-828 - Coverage for Charges Related to Dental 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 are issued or delivered in the State.    (b)    An entity subject to this section shall provide coverage for general anesthesia and associated hospital or ambulatory facility charges in conjunction with dental care provided to an enrollee or insured if the enrollee or insured:        (1)    (i)    is 7 years of age or younger or is developmentally disabled;            (ii)    is an individual for whom a successful result cannot be expected from dental care provided under local anesthesia because of a physical, intellectual, or other medically compromising condition of the enrollee or insured; and            (iii)    is an individual for whom a superior result can be expected from dental care provided under general anesthesia; or        (2)    (i)    is an extremely uncooperative, fearful, or uncommunicative child who is 17 years of age or younger with dental needs of such magnitude that treatment should not be delayed or deferred; and            (ii)    is an individual for whom lack of treatment can be expected to result in oral pain, infection, loss of teeth, or other increased oral or dental morbidity.    (c)    An entity subject to this section may require prior authorization for general anesthesia and associated hospital or ambulatory facility charges for dental care in the same manner that prior authorization is required for these benefits in connection with other covered medical care.    (d)    An entity subject to this section may restrict coverage for general anesthesia and associated hospital or ambulatory facility charges to dental care that is provided by:        (1)    a fully accredited specialist in pediatric dentistry;        (2)    a fully accredited specialist in oral and maxillofacial surgery; and        (3)    a dentist to whom hospital privileges have been granted.    (e)    The provisions of this section may not be construed to require coverage for the dental care for which the general anesthesia is provided.    (f)    The provisions of this section do not apply to dental care rendered for temporal mandibular joint disorders.
MD. Insurance Code Ann. §  15-829 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-829 - Coverage for Detection of Chlamydia

    (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 infection by one or more agents of the human papillomavirus; and            (ii)    is approved for this purpose by the federal Food and Drug Administration.        (4)    “Multiple risk factors” means having a prior history of a sexually transmitted disease, new or multiple sex partners, inconsistent use of barrier contraceptives, or cervical ectopy.    (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 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 contracts that are issued or delivered in the State.    (c)    An entity subject to this section shall:        (1)    provide coverage for an annual routine chlamydia screening test for:            (i)    women who are:                1.    under the age of 20 years if they are sexually active; and                2.    at least 20 years old if they have multiple risk factors; and            (ii)    men who have multiple risk factors; and        (2)    provide coverage for a human papillomavirus screening at the testing intervals outlined in the recommendations for cervical cytology screening developed by the American College of Obstetricians and Gynecologists.    (d)    (1)    Subject to paragraph (2) of this subsection, the coverage required under this section may be subject to a copayment or coinsurance requirement or deductible that an entity subject to this section imposes for similar coverages under the same policy or contract.        (2)    The copayment or coinsurance requirement or deductible imposed under paragraph (1) of this subsection may not be greater than the copayment or coinsurance requirement or deductible imposed by the entity for similar coverages.    (e)    Nothing in this section may be construed to prohibit an entity subject to this section from providing coverages that are greater than or more favorable to an insured or enrollee than the coverage required under this section.
MD. Insurance Code Ann. §  15-832 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-832 - Coverage for Removal of Testicle

    (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 groups under contracts that are issued or delivered in the State.    (b)    For a patient who receives less than 48 hours of inpatient hospitalization following the surgical removal of a testicle, or who undergoes the surgical removal of a testicle on an outpatient basis, an entity subject to this section shall provide coverage for:        (1)    one home visit scheduled to occur within 24 hours after discharge from the hospital or outpatient health care facility; and        (2)    an additional home visit if prescribed by the patient’s attending physician.    (c)    Each entity subject to this section shall provide notice annually to its enrollees and insureds about the coverage required under this section.
MD. Insurance Code Ann. §  15-832.1 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-832.1 - Inpatient Hospitalization Coverage Following Mastectomy

    (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 issued or delivered in the State; and        (2)    health maintenance organizations that provide inpatient hospital, medical, or surgical benefits to individuals or groups under contracts that are issued or delivered in the State.    (c)    An entity subject to this section shall provide coverage for the cost of inpatient hospitalization services for a patient for a minimum of 48 hours following a mastectomy.    (d)    A patient may request a shorter length of stay than that provided in subsection (c) of this section if the patient decides, in consultation with the patient’s attending physician, that less time is needed for recovery.    (e)    (1)    For a patient who receives less than 48 hours of inpatient hospitalization following a mastectomy or who undergoes a mastectomy on an outpatient basis, an entity subject to this section shall provide coverage for:            (i)    one home visit scheduled to occur within 24 hours after discharge from the hospital or outpatient health care facility; and            (ii)    an additional home visit if prescribed by the patient’s attending physician.        (2)    For a patient who remains in the hospital for at least the length of time provided under subsection (c) of this section, an entity subject to this section shall provide coverage for a home visit if prescribed by the attending physician.    (f)    An entity subject to this section may not deny, limit, or otherwise impair the participation of an attending physician under contract with the entity in providing health care services to enrollees or insureds for:        (1)    advocating the interest of a mastectomy patient through the entity’s utilization review or appeals system;        (2)    advocating more than 48 hours of inpatient hospital care for a patient with complications related to a mastectomy; or        (3)    prescribing a home visit under subsection (e)(1)(ii) or (2) of this section.    (g)    An entity subject to this section may not refuse reimbursement under subsection (e)(1) of this section if the services do not occur within the time specified.    (h)    An entity subject to this section shall provide notice annually to insureds and enrollees about the coverage provided by this section.
MD. Insurance Code Ann. §  15-834 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-834 - Coverage for Prostheses

    (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 contracts that are issued or delivered in the State.    (b)    An entity subject to this section shall provide coverage for a prosthesis that has been prescribed by a physician for an enrollee or insured who has undergone a mastectomy and has not had breast reconstruction.
MD. Insurance Code Ann. §  15-835 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-835 - Required Coverage for Habilitative Services

    (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 maintenance organization uses to review and preauthorize a treatment plan that a health care practitioner develops for a covered person using a variety of cost containment methods to control utilization, quality, and claims.    (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 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 contracts that are issued or delivered in the State.    (c)    (1)    An entity subject to this section:            (i)    shall provide coverage of habilitative services for insureds and enrollees who are children until at least the end of the month in which the insured or enrollee turns 19 years old; and            (ii)    may do so through a managed care system.        (2)    An entity subject to this section is not required to provide reimbursement for habilitative services delivered through early intervention or school services.    (d)    An entity subject to this section shall provide notice annually to its insureds and enrollees about the coverage required under this section:        (1)    in print; and        (2)    on its Web site.    (e)    Beginning November 1, 2013, a determination by an entity subject to this section of whether habilitative services covered under this section are medically necessary and appropriate to treat autism and autism spectrum disorders shall be made in accordance with regulations adopted by the Commissioner.
MD. Insurance Code Ann. §  15-836 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-836 - Hair Prosthesis

    (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 groups under contracts that are issued or delivered in the State.    (b)    (1)    Subject to paragraph (2) of this subsection, an entity subject to this section shall provide, for an enrollee or insured whose hair loss results from chemotherapy or radiation treatment for cancer, coverage for one hair prosthesis.        (2)    The cost of a hair prosthesis required under paragraph (1) of this subsection may not exceed $350.    (c)    To be covered under this section, a hair prosthesis must be prescribed by the oncologist in attendance.