Md. Code Ann., Ins. § 15-860
Recommended lung cancer screening or follow-up diagnostic imaging to assist in the diagnosis of lung cancer
Effective Jan 1, 2025Added by Acts 2023, c. 353, § 1, eff. Jan. 1, 2024; Acts 2023, c. 354, § 1, eff. Jan. 1, 2024. Amended by Acts 2024, c. 868, § 1, eff. Jan. 1, 2025.State of Maryland
(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)
- (1) An entity subject to this section shall provide coverage for recommended lung cancer screening or follow-up diagnostic imaging to assist in the diagnosis of lung cancer for individuals for which lung cancer screening or follow-up diagnostic imaging is recommended by the U.S. Preventative Services Task Force.
(2) The coverage required under paragraph (1) of this subsection:
- (i) shall include diagnostic ultrasound, magnetic resonance imaging, computed tomography, and image-guided biopsy; and
- (ii) may not be subject to a prior authorization requirement.
(c)
- (1) Except as provided in paragraph (2) of this subsection, an entity subject to this section may not impose a copayment, coinsurance, or deductible requirement on coverage for lung cancer screening or follow-up diagnostic imaging that is greater than the copay, coinsurance, or deductible requirement for breast cancer screening or diagnosis.
- (2) If an insured or enrollee is covered under a high-deductible health plan, as defined in 26 U.S.C. § 223, an entity subject to this section may subject follow-up diagnostic lung imaging to the deductible requirement of the high-deductible health plan.
Added by Acts 2023, c. 353, § 1, eff. Jan. 1, 2024; Acts 2023, c. 354, § 1, eff. Jan. 1, 2024. Amended by Acts 2024, c. 868, § 1, eff. Jan. 1, 2025.