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§ 15-1A-10. Cost sharing requirements

West's Annotated Code of MarylandInsuranceEffective: May 8, 2020

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 15. Health Insurance
Subtitle 1a--Consumer Protections (Refs & Annos)
Effective: May 8, 2020
MD Code, Insurance, § 15-1A-10
§ 15-1A-10. Cost sharing requirements
Currentness
In general
(a) Except as provided in subsections (b) and (c) of this section, a carrier shall provide coverage for and may not impose any cost-sharing requirements, including copayments, coinsurance, or deductibles for:
(1) evidence-based items or services that have in effect a rating of A or B in the current recommendations of the United States Preventive Services Task Force with respect to the individual involved;
(2) immunizations for routine use in children, adolescents, and adults that have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved, if the recommendation:
(i) has been adopted by the Director of the Centers for Disease Control and Prevention; and
(ii) is listed on the Immunization Schedules of the Centers for Disease Control and Prevention for routine use;
(3) with respect to infants, children, and adolescents, evidence-informed preventive care and screenings provided for in comprehensive guidelines supported by the Health Resources and Services Administration; and
(4) with respect to women:
(i) to the extent not provided in item (ii) of this item, preventive care and screenings as provided for in comprehensive guidelines supported by the Health Resources and Services Administration for purposes of § 2713(a)(4) of the federal Public Health Service Act; and
(ii) subject to § 15-826(c) of this title, contraceptive coverage as provided for in comprehensive guidelines supported by the Health Resources and Services Administration for purposes of § 2713(a)(4) of the federal Public Health Service Act.
Out-of-network providers
(b) To the extent that cost-sharing is otherwise allowed under federal or State law, a health benefit plan that uses a network of providers may impose cost-sharing requirements on the coverage described in subsection (a) of this section for items or services delivered by an out-of-network provider.
Construction of section
(c) This section may not be construed to prohibit a carrier from providing coverage for services in addition to those recommended by the United States Preventive Services Task Force or to deny coverage for services that are not recommended by the Task Force.

Credits

Added by Acts 2020, c. 620, § 1, eff. May 8, 2020; Acts 2020, c. 621, § 1, eff. May 8, 2020.
MD Code, Insurance, § 15-1A-10, MD INSURANCE § 15-1A-10
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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