Maryland 2025 Regular Session

Maryland Senate Bill SB476 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2
3	3	EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4	4	[Brackets] indicate matter deleted from existing law.
5	5	sb0476
6	6
7	7	SENATE BILL 476
8	8	J5, J4 5lr1399
9	9	CF 5lr1400
10	10	By: Senator Beidle
11	11	Introduced and read first time: January 22, 2025
12	12	Assigned to: Finance
13	13
14	14	A BILL ENTITLED
15	15
16	16	AN ACT concerning 1
17	17
18	18	Health Insurance – Genetic Testing and Cancer Imaging – Required Coverage 2
19	19	and Prohibited Cost–Sharing 3
20	20
21	21	FOR the purpose of requiring certain insurers, nonprofit health service plans, and health 4
22	22	maintenance organizations to provide coverage for genetic testing for certain 5
23	23	individuals who may have an increased risk of developing cancer and follow–up 6
24	24	evidence–based cancer imaging for individuals with an increased risk of developing 7
25	25	cancer; prohibiting certain insurers, nonprofit health service plans, and health 8
26	26	maintenance organizations from imposing a copayment, coinsurance, or deductible 9
27	27	requirement on coverage for genetic testing and follow–up evidence–based cancer 10
28	28	imaging; and generally relating to health insurance coverage for genetic testing and 11
29	29	cancer imaging. 12
30	30
31	31	BY adding to 13
32	32	Article – Insurance 14
33	33	Section 15–861 15
34	34	Annotated Code of Maryland 16
35	35	(2017 Replacement Volume and 2024 Supplement) 17
36	36
37	37	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 18
38	38	That the Laws of Maryland read as follows: 19
39	39
40	40	Article – Insurance 20
41	41
42	42	15–861. 21
43	43
44	44	(A) THIS SECTION APPLIES TO: 22
45	45
46	46	(1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 23
47	47	PROVIDE HOSPITAL , MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS 24 2 SENATE BILL 476
48	48
49	49
50	50	ON AN EXPENSE –INCURRED BASIS UNDER HEALTH I NSURANCE POLICIES OR 1
51	51	CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE; AND 2
52	52
53	53	(2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 3
54	54	HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS UNDER 4
55	55	CONTRACTS THAT ARE I SSUED OR DELIV ERED IN THE STATE. 5
56	56
57	57	(B) AN ENTITY SUBJECT TO THIS SECTION SHALL P ROVIDE COVERAGE FOR : 6
58	58
59	59	(1) GENETIC TESTING TO I DENTIFY WHETHER AN I NDIVIDUAL WITH A 7
60	60	PERSONAL OR FAMILY H ISTORY OF CANCER HAS AN INHERITED MUTATIO N 8
61	61	ASSOCIATED WITH AN I NCREASED RISK OF CAN CER IF THE GENETIC TES TING IS: 9
62	62
63	63	(I) RECOMMENDED BY A HEA LTH CARE PROFESSIONAL ; AND 10
64	64
65	65	(II) CONSISTENT WITH EVID ENCE–BASED, CLINICAL PRACTICE 11
66	66	GUIDELINES; AND 12
67	67
68	68	(2) IF AN INDIVIDUAL WHO UNDERGOES GENETI C TESTING FOR 13
69	69	WHICH COVERAGE IS PR OVIDED UNDER ITEM (1) OF THIS SUBSECTION IS 14
70	70	DETERMINED TO BE AT AN INCREASED RISK O F DEVELOPING CANCER , FOLLOW–UP 15
71	71	EVIDENCE–BASED CANCER IMAGING THAT: 16
72	72
73	73	(I) IS RECOMMENDED FOR T HE TYPE OF CANCER ID ENTIFIED 17
74	74	BY THE GENETIC TESTI NG; AND 18
75	75
76	76	(II) USES MODALITIES ESTA BLISHED IN THE MOST RECENT 19
77	77	VERSION OF THE NATIONAL COMPREHENSIVE CANCER NETWORK CLINICAL 20
78	78	PRACTICE GUIDELINES IN ONCOLOGY. 21
79	79
80	80	(C) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 22
81	81	AN ENTITY SUBJECT TO THIS SECTION MAY NOT IMPOSE A COPAYMENT , 23
82	82	COINSURANCE , OR DEDUCTIBLE REQUIREME NT ON COVERAGE FOR GENETIC 24
83	83	TESTING OR FOLLOW–UP EVIDENCE–BASED CANCER IMAGING AS DESCRIBED IN 25
84	84	SUBSECTION (B) OF THIS SECTION. 26
85	85
86	86	(2) (I) IF THE APPLICATION OF T HE REQUIREMENTS UNDE R 27
87	87	PARAGRAPH (1) OF THIS SUBSECTION W OULD RESULT IN HEALT H SAVINGS 28
88	88	ACCOUNT INELIGIBILIT Y UNDER 26 U.S.C. § 223, THE REQUIREMENT SHAL L APPLY 29
89	89	TO THE HEALTH SAVINGS ACCOU NT–QUALIFIED HIGH DEDUC TIBLE HEALTH PLANS 30
90	90	WITH RESPECT TO THE DEDUCTIB LE OF THE PLAN AFTER THE BENEFICIARY 31
91	91	SATISFIES THE MINIMUM DEDUCTIBLE UNDER 26 U.S.C. § 223. 32
92	92	SENATE BILL 476 3
93	93
94	94
95	95	(II) FOR ITEMS OR SERVICES THAT ARE PREVENTIVE CARE IN 1
96	96	ACCORDANCE WITH 26 U.S.C. § 223(C)(2)(C), THE REQUIREMENTS OF THIS 2
97	97	SUBSECTION SHALL APP LY REGARDLESS OF WHE THER THE BENEFICIARY STATUS 3
98	98	SATISFIES THE MINIMUM DEDUCTIBLE U NDER 26 U.S.C. § 223. 4
99	99
100	100	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 5
101	101	policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 6
102	102	after January 1, 2026. 7
103	103
104	104	SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 8
105	105	January 1, 2026. 9