(a) No health insurance company or health care provider contracted to provide health care to employees in a small group or large group plan may deny coverage to the employee or dependent on the basis of blood or blood derivatives. Blood and blood derivatives shall be covered and may be subject tomaximum limitations per annum.

(1) Guaranteed Availability.

(A) Prohibition of Preexisting Condition Exclusions or Other Discrimination Based on Health Status. As a condition of conducting health insurance coverage on Guam, a group health plan and a health insurance issuer offering group or individual health insurance coverage shall not impose any preexisting condition exclusion with respect to such plan or coverage, pursuant to Subsection 2 of this Section.

(B) Definition, for the purposes of this Part. The term “”preexisting condition exclusion”” means, with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact the condition was present before the date of enrollment for such coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before such date.

(2) Prohibition on Rescissions. For the purposes of this Section, and in conformance with SEC. 2712 [42
U.S.C. 300gg-12] Prohibition On Rescissions, a group health plan and a health insurance issuer offering group or individual health insurance coverage shall not rescind such
plan or coverage with respect to an enrollee once the enrollee is covered under such plan or coverage involved,
except that this Section shall not apply to a covered individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation
of material fact as prohibited by the terms of the plan or coverage. Such plan or coverage may not be cancelled
except with prior notice to the enrollee, and only as permitted under Sections 2702(c), 2703(b) or 2742(b) of the
Public Health Service Act.

SOURCE: Added by P.L. 32-235:2 (Jan. 2, 2015) as 11 Guam Code Ann. § 103121. Codified to this section by the Compiler pursuant to the authority granted by 1 Guam Code Ann. § 1606.

§ 18902. Coverage of Routine Costs of Care During
Approved Clinical Trials.

(a) A health insurance company or healthcare plan shall continue coverage of routine costs for any insured during the approved clinical trial.

(b) For the purposes of this Section, routine costs of care include any treatments, procedures, and services the insured may need while participating in the clinical trial that would normally be covered if the insured were not participating in a trial.

(c) For the purposes of this Section, approved clinical trials are designed to study new methods to prevent, detect, or treat cancer or another life-threatening illness. An approved clinical trial must meet any of the following conditions:

(1) be federally approved or funded – this means that one (1) or more of the organizations listed below approved or funded the clinical trial:

(A) the National Institutes of Health (NIH), including organizations under the NIH such as the National Cancer Institute (NCI);

(B) organizations funded by the NIH or NCI, including academic institutions, designated cancer centers, and cooperative groups;

(C) the Centers for Disease Control and
Prevention (CDC);

(D) the Agency for Health Care Research and
Quality (ARHQ);

(E) the Center for Medicare and Medicaid
Services (CMS);

(F) the Department of Defense, the Department of Veteran Affairs, or the Department of Energy, if the trial is subject to unbiased, scientific review that is similar to NIH requirements;

(2) have an investigational new drug application; or

(3) be excused from investigational new drug application requirements.

(d) Health insurance companies or healthcare plans are not required to cover the cost of any clinical trials.

SOURCE: Added by P.L. 35-128:2 (Dec. 29, 2021).

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ARTICLE 10
HEALTH INSURANCE COVERAGE; SCREENINGS