(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.
Structure Maryland Statutes
Subtitle 8 - Required Health Insurance Benefits
Section 15-801 - Benefits for Alzheimer's Disease and Care of Elderly Individuals
Section 15-803 - Payments for Blood Products
Section 15-804 - Coverage for Off-Label Use of Drugs
Section 15-805 - Reimbursement for Pharmaceutical Products
Section 15-806 - Choice of Pharmacy for Filling Prescriptions
Section 15-807 - Coverage for Medical Foods and Modified Food Products
Section 15-808 - Benefits for Home Health Care
Section 15-809 - Benefits for Hospice Care Services
Section 15-810 - Benefits for in Vitro Fertilization
Section 15-810.1 - Coverage for Standard Fertility Preservation Procedures
Section 15-811 - Hospitalization Benefits for Childbirth
Section 15-812 - Inpatient Hospitalization Coverage for Mothers and Newborn Children
Section 15-813 - Benefits for Disability Caused by Pregnancy or Childbirth
Section 15-814 - Coverage for Breast Cancer Screenings
Section 15-815 - Coverage for Reconstructive Breast Surgery
Section 15-816 - Benefits for Routine Gynecological Care
Section 15-817 - Coverage for Child Wellness Services
Section 15-818 - Benefits for Treatment of Cleft Lip and Cleft Palate
Section 15-819 - Coverage for Outpatient Services and Second Opinions
Section 15-820 - Benefits for Orthopedic Braces
Section 15-821 - Diagnostic and Surgical Procedures for Bones of Face, Neck, and Head
Section 15-822 - Coverage for Diabetes Equipment, Supplies, and Self-Management Training
Section 15-823 - Coverage for Osteoporosis Prevention and Treatment
Section 15-824 - Coverage for Maintenance Drugs
Section 15-825 - Coverage for Detection of Prostate Cancer
Section 15-826 - Coverage for Prescription Drugs
Section 15-826.1 - Coverage for Contraceptive Drugs and Devices
Section 15-826.2 - Coverage for Male Sterilization
Section 15-826.3 - Coverage for Fertility Awareness-Based Methods
Section 15-827 - Coverage for Patient Cost for Clinical Trials
Section 15-828 - Coverage for Charges Related to Dental Care
Section 15-829 - Coverage for Detection of Chlamydia
Section 15-830 - Referrals to Specialists
Section 15-831 - Coverage of Prescription Drugs
Section 15-832 - Coverage for Removal of Testicle
Section 15-832.1 - Inpatient Hospitalization Coverage Following Mastectomy
Section 15-833 - Extension of Benefits
Section 15-834 - Coverage for Prostheses
Section 15-835 - Required Coverage for Habilitative Services
Section 15-836 - Hair Prosthesis
Section 15-837 - Colorectal Cancer Screening Coverage
Section 15-838 - Hearing Aid Coverage for a Minor Child
Section 15-839 - Coverage for Treatment of Morbid Obesity
Section 15-840 - Coverage for Medically Necessary Residential Crisis Services
Section 15-841 - Coverage for Smoking Cessation Treatment
Section 15-842 - Copayment or Coinsurance for Prescription Drugs and Devices Limited
Section 15-843 - Coverage for Amino Acid-Based Elemental Formula
Section 15-844 - Benefits for Prosthetic Devices
Section 15-845 - Coverage for Refills of Prescription Eye Drops
Section 15-846 - Coverage for Cancer Chemotherapy
Section 15-847 - Coverage for Specialty Drugs
Section 15-847.1 - Copayment or Coinsurance Limits for Certain Drugs -- Annual Increase Regulated
Section 15-848 - Coverage for Ostomy Equipment and Supplies
Section 15-849 - Coverage for Abuse-Deterrent Opioid Analgesic Drug Products
Section 15-850 - Prior Authorizations for Opioid Antagonist
Section 15-851 - Prior Authorization for Drug Products to Treat Opioid Use Disorder -- Prohibition
Section 15-853 - Coverage for Lymphedema Diagnosis, Evaluation, and Treatment
Section 15-854 - Prior Authorization for Prescription Drug
Section 15-855 - Coverage for Pediatric Autoimmune Neuropsychiatric Disorders