reglab/housing_qa huggingface dataset:
MD. Insurance Code Ann. §  15-807 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-807 - Coverage for Medical Foods and Modified Food Products

    (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 gram of protein per serving; and                2.    intended to be used under the direction of a physician for the dietary treatment of an inherited metabolic disease.            (ii)    “Low protein modified food product” does not include a natural food that is naturally low in protein.        (4)    “Medical food” means a food that is:            (i)    intended for the dietary treatment of a disease or condition for which nutritional requirements are established by medical evaluation; and            (ii)    formulated to be consumed or administered enterally under the direction of a physician.    (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 written on an expense-incurred basis; and        (3)    provides coverage for a family member of the insured.    (c)    A policy or plan subject to this section shall include under the family member coverage, coverage for medical foods and low protein modified food products for the treatment of inherited metabolic diseases if the medical foods or low protein modified food products are:        (1)    prescribed as medically necessary for the therapeutic treatment of inherited metabolic diseases; and        (2)    administered under the direction of a physician.
MD. Insurance Code Ann. §  15-808 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|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 each individual, group, or blanket health insurance policy that is issued or delivered in the State by an insurer or nonprofit health service plan.    (c)    A policy subject to this section that provides coverage for inpatient hospital care on an expense-incurred basis shall provide benefits for the expenses of home health care that is provided by a person licensed under the Health Occupations Article.    (d)    Home health care shall be provided by:        (1)    a hospital that has a valid operating certificate and is certified to provide home health care services; or        (2)    a public or private health service or agency that is licensed as a home health agency under Title 19, Subtitle 4 of the Health - General Article to provide coordinated home health care.    (e)    (1)    A contract may limit the number of home health care visits, but not to fewer than 40 visits in a calendar year or in a continuous 12-month period for each individual covered under the contract.        (2)    In determining the benefits for home health care available to a covered individual:            (i)    each visit by a member of a home health care team is considered one home health care visit; and            (ii)    up to 4 hours of home health care service is considered one home health care visit.
MD. Insurance Code Ann. §  15-809 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|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 offer benefits for hospice care services to its policyholders or beneficiaries.    (b)    Each nonprofit health service plan shall offer benefits for hospice care services to its subscribers.
MD. Insurance Code Ann. §  15-810.1 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|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 as established by the American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, or the American Society of Clinical Oncology.        (4)    (i)    “Standard fertility preservation procedures” means procedures to preserve fertility that are consistent with established medical practices and professional guidelines published by the American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, or the American Society of Clinical Oncology.            (ii)    “Standard fertility preservation procedures” includes sperm and oocyte cryopreservation and evaluations, laboratory assessments, medications, and treatments associated with sperm and oocyte cryopreservation.            (iii)    “Standard fertility preservation procedures” does not include the storage of sperm or oocytes.    (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 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)    Except as provided in subsection (d) of this section, an entity subject to this section shall provide coverage for standard fertility preservation procedures:        (1)    performed on a policyholder or subscriber or on the covered dependent of a policyholder or subscriber; and        (2)    that are medically necessary to preserve fertility for a policyholder or subscriber or for the covered dependent of a policyholder or subscriber due to a need for medical treatment that may directly or indirectly cause iatrogenic infertility.    (d)    An entity subject to this section may not be required to provide coverage under subsection (c) of this section to a religious organization that requests and receives an exclusion from in vitro fertilization coverage under § 15–810(i) of this subtitle.
MD. Insurance Code Ann. §  15-811 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-811 - Hospitalization Benefits for Childbirth

    (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 provisions of subsection (a) of this section and § 15-812 of this subtitle, whenever a mother is required to remain hospitalized after childbirth for medical reasons and the mother requests that the newborn remain in the hospital, the insurer or nonprofit health service plan shall pay the cost of additional hospitalization for the newborn for up to 4 days.        (2)    The attending physician or certified nurse midwife of the mother, or designee of the attending physician or certified nurse midwife, shall provide notice to the mother of the provisions of paragraph (1) of this subsection.
MD. Insurance Code Ann. §  15-813 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-813 - Benefits for Disability Caused by Pregnancy or Childbirth

    (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 subject to this section that provides benefits for temporary disability shall offer the policyholder the option of providing benefits for temporary disability caused or contributed to by pregnancy or childbirth.    (c)    The benefits under this section shall be provided to the same extent and on the same terms as the benefits provided for any other covered disability.
MD. Insurance Code Ann. §  15-814 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|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 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)    Subject to paragraph (2) of this subsection, an entity subject to this section shall provide coverage for breast cancer screening in accordance with the latest screening guidelines issued by the American Cancer Society.        (2)    The coverage required under this section shall include coverage for digital tomosynthesis that, under accepted standards in the practice of medicine, the treating physician determines is medically appropriate and necessary for an enrollee or insured.    (d)    An entity subject to this section is not required to cover breast cancer screenings used to identify breast cancer in asymptomatic women that are provided by a facility that is not accredited by the American College of Radiology or certified or licensed under a program established by the State.    (e)    (1)    An entity subject to this section may not impose a deductible on the coverage required under this section.        (2)    Each health insurance policy and certificate issued by an entity subject to this section shall contain a notice of the prohibition established by paragraph (1) of this subsection in a form approved by the Commissioner.        (3)    An entity subject to this section may not impose a copayment or coinsurance requirement for digital tomosynthesis that is greater than a copayment or coinsurance requirement for other breast cancer screenings for which coverage is required under this section.
MD. Insurance Code Ann. §  15-815 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|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 contracts issued by:        (1)    insurers and nonprofit health service plans that provide medical and surgical benefits to individuals or groups on an expense–incurred basis under health insurance contracts that are issued or delivered in the State; and        (2)    health maintenance organizations that provide medical and surgical benefits to individuals or groups under contracts that are issued or delivered in the State.    (c)    A contract subject to this section shall provide coverage for:        (1)    reconstructive breast surgery, including coverage for all stages of reconstructive breast surgery performed on a nondiseased breast to establish symmetry with the diseased breast when reconstructive breast surgery is performed on the diseased breast; and        (2)    physical complications of all stages of mastectomy, including lymphedemas, in a manner determined in consultation with the attending physician and the patient.
MD. Insurance Code Ann. §  15-816 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|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 are issued or delivered in the State.    (b)    An entity subject to this section:        (1)    shall classify an obstetrician/gynecologist as a primary care provider; or        (2)    if the obstetrician/gynecologist chooses not to be a primary care provider, shall allow a woman to receive routine gynecological care from an in-network obstetrician/gynecologist without requiring the woman to visit a primary care provider first, if:            (i)    the care is medically necessary, including care that is routine;            (ii)    after each visit for gynecological care, the obstetrician/gynecologist communicates with the woman’s primary care provider about any diagnosis or treatment rendered; and            (iii)    the obstetrician/gynecologist confers with the primary care provider before performing any diagnostic procedure that is not routine gynecological care rendered during an annual visit.    (c)    If an entity subject to this section classifies an obstetrician/gynecologist as a primary care provider as provided in subsection (b) of this section, and a woman does not choose an obstetrician/gynecologist as the woman’s primary care provider, the entity shall allow the woman an annual visit to an in-network obstetrician/gynecologist for routine gynecological care without requiring the woman to visit the woman’s primary care provider first, whether or not the primary care provider is qualified to and regularly does provide routine gynecological care.    (d)    (1)    An entity subject to this section shall allow a woman to receive medically necessary, routine obstetric and gynecological care from an in-network, certified nurse midwife or any other in-network provider authorized under the Health Occupations Article to provide obstetric and gynecological services without first requiring the woman to visit a primary care provider.        (2)    A certified nurse midwife or other nonphysician provider authorized under the Health Occupations Article to provide obstetric and gynecological services shall consult with an obstetrician/gynecologist with whom the certified nurse midwife or other provider has a collaborative agreement, in accordance with the collaborative agreement, regarding any care rendered under this subsection.
MD. Insurance Code Ann. §  15-818 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|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 in the State by a nonprofit health service plan; and        (3)    each contract that provides hospital, medical, or surgical benefits to individuals or groups and is issued or delivered in the State by a health maintenance organization.    (b)    A policy, contract, or certificate subject to this section shall include benefits for inpatient or outpatient expenses arising from orthodontics, oral surgery, and otologic, audiological, and speech/language treatment involved in the management of the birth defect known as cleft lip or cleft palate or both.
MD. Insurance Code Ann. §  15-819 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|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 an inpatient service in an acute general hospital shall provide coverage for:        (1)    a corresponding outpatient service that is provided to the insured instead of the inpatient service because of the denial, after review under a utilization review program, of a request by the attending physician for an inpatient admission; and        (2)    an objective second opinion given to the insured when required by a utilization review program under § 19-319 of the Health - General Article.
MD. Insurance Code Ann. §  15-820 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|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 plan and that provides hospital benefits shall provide benefits for orthopedic braces.
MD. Insurance Code Ann. §  15-821 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|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 or joint of the skeletal structure may not exclude or deny coverage for the same diagnostic or surgical procedure involving a bone or joint of the face, neck, or head if, under the accepted standards of the profession of the health care provider rendering the service, the procedure is medically necessary to treat a condition caused by a congenital deformity, disease, or injury.        (2)    This subsection does not apply to intraoral prosthetic devices.    (c)    (1)    This section does not affect any other coverage required under this article or restrict the scope of coverage under a policy or contract subject to this section.        (2)    This section is not intended to encourage surgical procedures over appropriate nonsurgical procedures, or to prohibit the continued coverage of nonsurgical procedures in the treatment of a bone or joint of the face, neck, or head.
MD. Insurance Code Ann. §  15-823 (2021)
2021 Maryland Statutes|Insurance|Title 15 - Health Insurance|Subtitle 8 - Required Health Insurance Benefits|Section 15-823 - Coverage for Osteoporosis Prevention and Treatment

    (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 specific sign suggestive of spinal osteoporosis, including roentgenographic osteopenia or roentgenographic evidence suggestive of collapse, wedging, or ballooning of one or more thoracic or lumbar vertebral bodies, who is a candidate for therapeutic intervention or for an extensive diagnostic evaluation for metabolic bone disease;            (iii)    an individual receiving long–term glucocorticoid (steroid) therapy;            (iv)    an individual with primary hyperparathyroidism; or            (v)    an individual being monitored to assess the response to or efficacy of an approved osteoporosis drug therapy.    (b)    This section applies to:        (1)    each individual hospital or major medical insurance policy of an insurer that is delivered or issued for delivery in the State and is written on an expense–incurred basis;        (2)    each group or blanket health insurance policy of an insurer that is issued or delivered in the State and is written on an expense–incurred basis;        (3)    each individual or group medical or major medical contract or certificate of a nonprofit health service plan that is issued or delivered in the State and is written on an expense–incurred basis; and        (4)    each individual or group contract of a health maintenance organization that is issued or delivered in the State.    (c)    A policy, contract, or certificate subject to this section shall include coverage for qualified individuals for reimbursement for bone mass measurement for the prevention, diagnosis, and treatment of osteoporosis when the bone mass measurement is requested by a health care provider for the qualified individual.