EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb0830*
HOUSE BILL 830
J5, J4 5lr1400
CF SB 476
By: Delegates D. Jones, White Holland, Bagnall, Fennell, Forbes, Guzzone, Kipke,
Ruth, and Wilkins Wilkins, Alston, Bhandari, Chisholm, Cullison, Hill,
Hutchinson, S. Johnson, Kaiser, Kerr, Lopez, Martinez, M. Morgan,
Pena–Melnyk, Reilly, Rosenberg, Ross, Szeliga, Taveras, Woods, and
Woorman
Introduced and read first time: January 29, 2025
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 6, 2025
CHAPTER ______
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 2 HOUSE BILL 830
Article – Insurance 1
15–861. 2
(A) THIS SECTION APPLIES TO: 3
(1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 4
PROVIDE HOSPITAL , MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS 5
ON AN EXPENSE –INCURRED BASIS UNDER HEALTH INSURANCE POL ICIES OR 6
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE; AND 7
(2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 8
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS UNDER 9
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 10
(B) AN ENTITY SUBJECT TO THIS SECTION SHALL P ROVIDE COVERAGE FOR : 11
(1) GENETIC TESTING TO I DENTIFY WHETHER AN I NDIVIDUAL WITH A 12
PERSONAL OR FAMILY HISTORY OF CANCER HAS AN INHERI TED MUTATION 13
ASSOCIATED WITH AN I NCREASED RISK OF CAN CER IF THE GENETIC T ESTING IS: 14
(I) RECOMMENDED BY A HEA LTH CARE PROFESSIONA L; AND 15
(II) CONSISTENT WITH EVID ENCE–BASED, CLINICAL PRACTICE 16
GUIDELINES; AND 17
(2) IF AN INDIVIDUAL WHO UNDERGOES GENETIC TE STING FOR 18
WHICH COVERAGE IS PR OVIDED UNDER ITEM (1) OF THIS SUBSECTION I S 19
DETERMINED TO BE AT AN INCREASED RISK OF DEVELOPING CANCER , FOLLOW–UP 20
EVIDENCE–BASED CANCER IMAGING THAT: 21
(I) IS RECOMMENDED FOR THE TYPE OF CANCER I DENTIFIED 22
BY THE GENETIC TESTI NG; AND 23
(II) USES MODALITIES ESTA BLISHED IN THE MOST RECENT 24
VERSION OF THE NATIONAL COMPREHENSIVE CANCER NETWORK CLINICAL 25
PRACTICE GUIDELINES IN ONCOLOGY. 26
(C) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 27
AN ENTITY SUBJECT TO THIS SECTION MAY NOT IMPOSE A COPAYMENT , 28
COINSURANCE , OR DEDUCTIBLE REQUIR EMENT ON COVERAGE FO R GENETIC 29
TESTING OR FOLLOW –UP EVIDENCE –BASED CANCER IMAGING AS DESCRIBED IN 30
SUBSECTION (B) OF THIS SECTION. 31 HOUSE BILL 830 3
(2) (I) IF THE APPLICATION OF T HE REQUIREMENTS UNDE R 1
PARAGRAPH (1) OF THIS SUBSECTION W OULD RESULT IN HEALT H SAVINGS 2
ACCOUNT INELIGIBILIT Y UNDER 26 U.S.C. § 223, THE REQUIREMENT SHAL L APPLY 3
TO THE HEALTH SAVING S ACCOUNT–QUALIFIED HIGH DEDUC TIBLE HEALTH PLANS 4
WITH RESPECT TO THE DEDUCTI BLE OF THE PLAN AFTE R THE BENEFICIARY 5
SATISFIES THE MINIMU M DEDUCTIBLE UNDER 26 U.S.C. § 223. 6
(II) FOR ITEMS OR SERVICES THAT ARE PREVENTIVE CARE IN 7
ACCORDANCE WITH 26 U.S.C. § 223(C)(2)(C), THE REQUIREMENTS OF THIS 8
SUBSECTION SHAL L APPLY REGARDLESS O F WHETHER THE BENEFI CIARY STATUS 9
SATISFIES THE MINIMU M DEDUCTIBLE UNDER 26 U.S.C. § 223. 10
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 11
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 12
after January 1, 2026. 13
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 14
January 1, 2026. 15
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.