New health in­sur­ance laws in Mary­land tak­ing ef­fect

The Avenue News - - NEWS - By BRIAN WITTE

AN­NAPO­LIS, MD. (AP) — New laws in Mary­land will re­quire in­sur­ers to pro­vide ben­e­fits for pa­tients with cer­tain health con­di­tions, in­clud­ing high blood su­gar lev­els that pose a risk for di­a­betes as well as a par­tic­u­lar kind of chronic swelling.

One law tak­ing ef­fect Tues­day ex­pands cov­er­age for equip­ment, sup­plies and self-man­age­ment train­ing to ap­ply to el­e­vated or im­paired glu­cose lev­els caused by pre­di­a­betes. That’s a con­di­tion when blood su­gar lev­els are el­e­vated but not high enough to be di­ag­nosed as di­a­betes. The new man­date also will ap­ply to treat­ing im­paired glu­cose lev­els in­duced by preg­nancy.

About 1.6 mil­lion adults in Mary­land have pre­di­a­betes, ac­cord­ing to the Amer­i­can Di­a­betes As­so­ci­a­tion. It is usu­ally treated with di­etary changes, ex­er­cise and weight loss. The new law also al­lows re­im­burse­ment for ser­vices from a li­censed di­eti­tian or nu­tri­tion­ist for the treat­ment of pre­di­a­betes and obe­sity.

An­other new law will re­quire health in­sur­ers to cover treat­ment of a chronic swelling, of­ten in an arm or leg, known as lym­phedema. That’s an ab­nor­mal col­lec­tion of fluid just be­neath the skin. It usu­ally de­vel­ops when lymph ves­sels are dam­aged or lymph nodes are re­moved. If left un­treated, it can lead to chronic in­flam­ma­tion, in­fec­tion and hard­en­ing of the skin that can re­sult in fur­ther lymph ves­sel dam­age and dis­tor­tion of the shape of af­fected body parts.

Sev­eral other states, in­clud­ing Cal­i­for­nia, Mas­sachusetts, North Carolina and Vir­ginia, man­date health in­sur­ance cov­er­age for lym­phedema, ac­cord­ing to an anal­y­sis of the law by the Mary­land De­part­ment of Leg­isla­tive Ser­vices. North Carolina and Vir­ginia specif­i­cally man­date cov­er­age for equip­ment, sup­plies and self­man­age­ment train­ing.

A De­cem­ber 2016 re­port pre­pared for the Mary­land Health Care Com­mis­sion found an es­ti­mated 7,400 fully in­sured peo­ple in the state had lym­phedema in 2014. The re­port by No­vaRest, Inc. also found that the man­date would not have a ma­te­rial im­pact on uti­liza­tion or the to­tal cost of health care in Mary­land. While all in­sur­ance car­ri­ers pro­vide cov­er­age for lym­phedema when med­i­cally nec­es­sary, cov­er­age lim­its such as max­i­mum al­low­able ben­e­fit or num­ber of vis­its may ap­ply.

Here’s a look at some other new laws af­fect­ing health in­sur­ance cov­er­age in Mary­land:

FER TILITY AWARE­NESS A new law will re­quire in­sur­ers to cover in­struc­tion by a li­censed health care provider on “fer­til­ity aware­ness-based meth­ods,” which are ways of iden­ti­fy­ing times of fer­til­ity and in­fer­til­ity to avoid preg­nancy.

FER­TIL­ITY PRESER­VA­TION

Health in­sur­ers will be re­quired to cover fer­til­ity preser­va­tion pro­ce­dures for peo­ple who need med­i­cal treat­ment that could di­rectly or in­di­rectly cause “ia­tro­genic in­fer­til­ity,” which is in­fer­til­ity caused by cancer treat­ments.

LO­CAL HEALTH DE­PART­MENTS

In­sur­ers will be re­quired to com­pen­sate lo­cal health de­part­ments that pro­vide be­hav­ioral health ser­vices in parts of the state where lo­cal health de­part­ments are the only providers of be­hav­ioral health ser­vices.

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