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§ 15-151. Gender-affirming treatment

West's Annotated Code of MarylandHealth--GeneralEffective: October 1, 2023

West's Annotated Code of Maryland
Health--General
Title 15. Assistance Programs (Refs & Annos)
Subtitle 1. Medical and Pharmacy Assistance Programs (Refs & Annos)
Effective: October 1, 2023
MD Code, Health - General, § 15-151
§ 15-151. Gender-affirming treatment
Definitions
(a)(1) In this section the following words have the meanings indicated.
(2)(i) “Gender-affirming treatment” means any medically necessary treatment consistent with current clinical standards of care prescribed by a licensed health care provider for the treatment of a condition related to the individual's gender identity.
(ii) “Gender-affirming treatment” includes:
1. Hormone therapy, hormone blockers, and puberty blockers;
2. Hair alteration for the purposes of altering secondary sex characteristics and surgical site preparation;
3. Alterations to voice, voice therapy, and voice lessons;
4. Alterations to abdomen, chest, trunk, and buttocks;
5. Alterations to the face and neck;
6. Alterations to the genitals and gonads;
7. Laser treatment for scars from gender-affirming treatment;
8. Standard fertility preservation procedures, as set forth in § 15-810.1 of the Insurance Article;
9. Revisions to previous treatments and reversal of treatments;
10. Combinations of gender-affirming procedures; and
11. Other treatments as prescribed to suppress the development of endogenous secondary sex characteristics, align the individual's appearance or physical body with gender identity, and alleviate symptoms of clinically significant distress resulting from gender dysphoria.
(iii) “Gender-affirming treatment” may include treatment described in the current clinical standards of care for gender-affirming treatment published by the World Professional Association for Transgender Health.
(3) “Gender identity” has the meaning stated in § 20-101 of the State Government Article.
Legislative intent
(b) It is the intent of the General Assembly that the Program provide gender-affirming treatment to all Program recipients for whom gender-affirming treatment is medically necessary, including transgender, nonbinary, intersex, two-spirit, and other gender diverse individuals.
In general
(c)(1) The Program shall provide coverage for medically necessary gender-affirming treatment in a nondiscriminatory manner.
(2) The gender-affirming treatment shall be assessed according to nondiscriminatory criteria that are consistent with current clinical standards of care.
(3) The Program may not deny or limit coverage for gender-affirming treatment when that treatment is:
(i) Prescribed to a Program recipient because of, related to, or consistent with the recipient's gender identity;
(ii) Medically necessary; and
(iii) Prescribed in accordance with current clinical standards of care.
(4) The Program may not deny or limit coverage for gender-affirming treatment based on the Program recipient's gender identity.
(5) The Program may not exclude gender-affirming treatment, including revisions to prior gender-affirming treatment, on the basis that the treatment is a cosmetic service.
(6) The Program may not establish a categorical exclusion for a particular gender-affirming treatment.
(7) The Program may not issue an adverse benefit determination denying or limiting access to gender-affirming treatment unless a health care provider with experience prescribing or delivering gender-affirming treatment has reviewed and confirmed the appropriateness of the adverse benefit determination.
Reports
(d)(1) On or before December 1 each year, beginning in 2024, each managed care organization shall submit to the Department a report that includes, for each health care provider offering gender-affirming treatment with which the managed care organization has an active contract and that consents to the inclusion:
(i) The name and location of the health care provider;
(ii) The types of gender-affirming treatment provided by the health care provider; and
(iii) Whether the health care provider consents to being publicly listed as part of the Department's annual report required under paragraph (2) of this subsection.
(2)(i) On or before January 1 each year, beginning in 2025, the Department shall compile an annual report on geographic access to gender-affirming treatment across the State.
(ii) The report shall include, for each health care provider offering gender-affirming treatment to Program recipients and whose consent to the inclusion is indicated in a report submitted under paragraph (1) of this subsection:
1. The name and location of the health care provider;
2. The managed care organizations that have active contracts with the health care provider; and
3. The types of gender-affirming treatment provided by the health care provider.
(iii) The Department shall publish the report in a conspicuous manner on the Department's website.
(3) The Department and each managed care organization shall include the name, location, and types of services for each provider offering gender-affirming treatment in their provider directories.

Credits

Added by Acts 2023, c. 252, § 1, eff. Oct. 1, 2023; Acts 2023, c. 253, § 1, eff. Oct. 1, 2023.
MD Code, Health - General, § 15-151, MD HEALTH GEN § 15-151
Current through legislation effective through May 9, 2024, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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