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§ 15-821. Diagnostic or surgical procedures for bones of face, neck, and head

West's Annotated Code of MarylandInsurance

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 15. Health Insurance
Subtitle 8. Required Health Insurance Benefits (Refs & Annos)
MD Code, Insurance, § 15-821
§ 15-821. Diagnostic or surgical procedures for bones of face, neck, and head
Application of section
(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.
Coverage for diagnostic or surgical procedures for bones of face, neck, and head
(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.
Construction of section with other insurance coverage
(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.

Credits

Added by Acts 1997, c. 35, § 2, eff. Oct. 1, 1997.
Formerly Art. 48A, § 490K.
MD Code, Insurance, § 15-821, MD INSURANCE § 15-821
Current through legislation effective through April 9, 2023, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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