EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0830*
HOUSE BILL 830
J5, J4 5lr1400
CF SB 476
By: Delegates D. Jones, White Holland, Bagnall, Fennell, Forbes, Guzzone, Kipke,
Ruth, and Wilkins
Introduced and read first time: January 29, 2025
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Health Insurance – Genetic Testing and Cancer Imaging – Required Coverage 2
and Prohibited Cost–Sharing 3
FOR the purpose of requiring certain insurers, nonprofit health service plans, and health 4
maintenance organizations to provide coverage for genetic testing for certain 5
individuals who may have an increased risk of developing cancer and follow–up 6
evidence–based cancer imaging for individuals with an increased risk of developing 7
cancer; prohibiting certain insurers, nonprofit health service plans, and health 8
maintenance organizations from imposing a copayment, coinsurance, or deductible 9
requirement on coverage for genetic testing and follow–up evidence–based cancer 10
imaging; and generally relating to health insurance coverage for genetic testing and 11
cancer imaging. 12
BY adding to 13
Article – Insurance 14
Section 15–861 15
Annotated Code of Maryland 16
(2017 Replacement Volume and 2024 Supplement) 17
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 18
That the Laws of Maryland read as follows: 19
Article – Insurance 20
15–861. 21
(A) THIS SECTION APPLIES TO: 22
2 HOUSE BILL 830
(1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 1
PROVIDE HOSPITAL , MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUP S 2
ON AN EXPENSE –INCURRED BASIS UNDER HEALTH INSURANCE POL ICIES OR 3
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE; AND 4
(2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 5
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS UNDER 6
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 7
(B) AN ENTITY SUBJECT TO THIS SECTION SHALL P ROVIDE COVERAGE FOR : 8
(1) GENETIC TESTING TO I DENTIFY WHETHER AN I NDIVIDUAL WITH A 9
PERSONAL OR FAMILY H ISTORY OF CANCER HA S AN INHERITED MUTAT ION 10
ASSOCIATED WITH AN I NCREASED RISK OF CAN CER IF THE GENETIC T ESTING IS: 11
(I) RECOMMENDED BY A HEA LTH CARE PROFESSIONA L; AND 12
(II) CONSISTENT WITH EVID ENCE–BASED, CLINICAL PRACTICE 13
GUIDELINES; AND 14
(2) IF AN INDIVIDUAL WHO UNDERGOES GENETIC TE STING FOR 15
WHICH COVERAGE IS PR OVIDED UNDER ITEM (1) OF THIS SUBSECTION I S 16
DETERMINED TO BE AT AN INCREASED RISK OF DEVELOPING CANCER , FOLLOW–UP 17
EVIDENCE–BASED CANCER IMAGING THAT: 18
(I) IS RECOMMENDED FOR T HE TYPE OF CANCER ID ENTIFIED 19
BY THE GENETIC TESTI NG; AND 20
(II) USES MODALITIES ESTA BLISHED IN THE MOST RECENT 21
VERSION OF THE NATIONAL COMPREHENSIVE CANCER NETWORK CLINICAL 22
PRACTICE GUIDELINES IN ONCOLOGY. 23
(C) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 24
AN ENTITY SUBJECT TO THIS SECT ION MAY NOT IMPOSE A COPAYMENT , 25
COINSURANCE , OR DEDUCTIBLE REQUIR EMENT ON COVERAGE FO R GENETIC 26
TESTING OR FOLLOW –UP EVIDENCE –BASED CANCER IMAGING AS DESCRIBED IN 27
SUBSECTION (B) OF THIS SECTION. 28
(2) (I) IF THE APPLICATION OF THE REQUI REMENTS UNDER 29
PARAGRAPH (1) OF THIS SUBSECTION W OULD RESULT IN HEALT H SAVINGS 30
ACCOUNT INELIGIBILIT Y UNDER 26 U.S.C. § 223, THE REQUIREMENT SHAL L APPLY 31
TO THE HEALTH SAVING S ACCOUNT–QUALIFIED HIGH DEDUC TIBLE HEALTH PLANS 32 HOUSE BILL 830 3
WITH RESPECT TO THE DEDUCTIBLE OF TH E PLAN AFTER THE BEN EFICIARY 1
SATISFIES THE MINIMU M DEDUCTIBLE UNDER 26 U.S.C. § 223. 2
(II) FOR ITEMS OR SERVICES THAT ARE PREVENTIVE CARE IN 3
ACCORDANCE WITH 26 U.S.C. § 223(C)(2)(C), THE REQUIREMENTS OF THIS 4
SUBSECTION SHALL APP LY REGARDLESS OF WHE THER THE BENEFICIARY STAT US 5
SATISFIES THE MINIMU M DEDUCTIBLE UNDER 26 U.S.C. § 223. 6
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 7
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 8
after January 1, 2026. 9
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take e ffect 10
January 1, 2026. 11