<?xml version='1.0' encoding='utf-8'?>
<section article="gin" article_name="Insurance" number="15-826.1" title_number="15" title_name="Health Insurance" subtitle_number="8" subtitle_name="Required Health Insurance Benefits">
  <level label="a">
    <text>In this section, “authorized prescriber” has the meaning stated in § 12–101 of the Health Occupations Article.</text>
  </level>
  <level label="b">
    <text>This section applies to:</text>
    <level label="1">
      <text>insurers and nonprofit health service plans that provide coverage for contraceptive drugs and devices under individual, group, or blanket health insurance policies or contracts that are issued or delivered in the State; and</text>
    </level>
    <level label="2">
      <text>health maintenance organizations that provide coverage for contraceptive drugs and devices under individual or group contracts that are issued or delivered in the State.</text>
    </level>
  </level>
  <level label="c">
    <level label="1">
      <text>This subsection does not apply to a health benefit plan that is a grandfathered health plan, as defined in § 1251 of the Affordable Care Act.</text>
    </level>
    <level label="2">
      <text>An entity subject to this section:</text>
      <level label="i">
        <text>except for a drug or device for which the U.S. Food and Drug Administration has issued a black box warning, may not apply a prior authorization requirement for a contraceptive drug or device that is:</text>
        <level label="1">
          <level label="A">
            <text>an intrauterine device; or</text>
          </level>
        </level>
        <level label="B">
          <text>an implantable rod;</text>
        </level>
        <level label="2">
          <text>approved by the U.S. Food and Drug Administration; and</text>
        </level>
        <level label="3">
          <text>obtained under a prescription written by an authorized prescriber; and</text>
        </level>
      </level>
      <level label="ii">
        <text>except as provided in paragraph (3) of this subsection, may not apply a copayment or coinsurance requirement for a contraceptive drug or device that is:</text>
        <level label="1">
          <text>approved by the U.S. Food and Drug Administration; and</text>
        </level>
        <level label="2">
          <text>obtained under a prescription written by an authorized prescriber.</text>
        </level>
      </level>
    </level>
    <level label="3">
      <text>An entity subject to this section may apply a copayment or coinsurance requirement for a contraceptive drug or device that, according to the U.S. Food and Drug Administration, is therapeutically equivalent to another contraceptive drug or device that is available under the same policy or contract without a copayment or coinsurance requirement.</text>
    </level>
  </level>
  <level label="d">
    <level label="1">
      <text>An entity subject to this section shall provide coverage for a single dispensing to an insured or an enrollee of a supply of prescription contraceptives for up to a 12–month period.</text>
    </level>
    <level label="2">
      <text>Whenever an entity subject to this section increases the copayment for a single dispensing of a supply of prescription contraceptives for up to a 12–month period, the entity shall also increase proportionately the dispensing fee paid to the pharmacist.</text>
    </level>
    <level label="3">
      <text>This subsection may not be construed to require a provider to prescribe, furnish, or dispense 12 months of contraceptives at one time.</text>
    </level>
  </level>
  <level label="e">
    <level label="1">
      <text>Subject to paragraph (2) of this subsection, an entity subject to this section:</text>
      <level label="i">
        <text>shall provide coverage without a prescription for all contraceptive drugs approved by the U.S. Food and Drug Administration and available by prescription and over the counter; and</text>
      </level>
      <level label="ii">
        <text>may not apply a copayment or coinsurance requirement for a contraceptive drug dispensed without a prescription under item (i) of this paragraph that exceeds the copayment or coinsurance requirement for the contraceptive drug dispensed under a prescription.</text>
      </level>
    </level>
    <level label="2">
      <text>An entity subject to this section:</text>
      <level label="i">
        <text>may only be required to provide point–of–sale coverage under paragraph (1)(i) of this subsection at in–network pharmacies; and</text>
      </level>
      <level label="ii">
        <text>may limit the frequency with which the coverage required under paragraph (1)(i) of this subsection is provided.</text>
      </level>
    </level>
  </level>
</section>
