Md. Code Regs. 10.67.06.26-3

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.67.06.26-3 - Gender-Affirming Treatment

A. An MCO shall provide medically necessary gender-affirming treatment services which include but are not limited to the following:

(1) Hormone therapy, hormone blockers, and puberty blockers;

(2) Hair alteration for the purposes of altering secondary sex characteristics and surgical site preparation;

(3) Alterations to voice, voice therapy, and voice lessons;

(4) Alterations to abdomen, chest, trunk, and buttocks;

(5) Alterations to the face and neck;

(6) Alterations to the genitals and gonads;

(7) Laser treatment for scars from gender-affirming treatment;

(8) Standard fertility preservation procedures as set forth in Insurance Article, § 15-810.1, Annotated Code of Maryland;

(9) Revisions to previous treatments and reversal of treatments;

(10) Combinations of gender-affirming procedures; and

(11) Other treatments as prescribed to suppress the development of endogenous secondary sex characteristics, align the individual's appearance of physical body with gender identity, and alleviate symptoms of clinically significant distress resulting from gender dysphoria.

B. An MCO may not issue an adverse benefit determination denying or limiting access to gender-affirming treatment unless a health care provider with experience prescribing or delivering gender-affirming treatment has reviewed and confirmed the appropriateness of the adverse benefit determination.

Md. Code Regs. 10.67.06.26-3

Regulations .26-3 recodified from 10.09.67.26-3 effective 46:22 Md. R. 976, eff. 11/1/2019; amended effective 51:12 Md. R. 620, eff. 6/24/2024.