WILLIAM DONALD SCHAEFER, Governor                        Ch. 5

Occurred: Ch. 416, Acts of 1970. Language became
obsolete on internal date.

[370Y.] 470Y.

(a)  Every insurer proposing to issue or deliver a health
insurance policy or contract or administer a health benefit
program which provides for the coverage of hospital benefits and
the utilization review of such benefits shall:

(1)  Have a certificate in accordance with Subtitle 13
of Title 19 of the Health - General Article;

(2)  Contract with a private review agent that has a
certificate in accordance with Subtitle 13 of Title 19 of the
Health - General Article; or

(3)  Contract with or delegate to a hospital
utilization review program approved under § 19-319(d) of the
Health - General Article.

(b)  Notwithstanding any other provision of this article,
for claims where the medical necessity of the provision of a
covered benefit is disputed, an insurer that does not meet the
requirements of subsection (a) of this section shall pay any
person or hospital entitled to reimbursement under the policy,
contract, or certificate in accordance with the determination of
medical necessity by the hospital utilization review program
approved under § 19-319(d) of the Health - General Article.

DRAFTER'S NOTE:

Error: Incorrect section number in Article 48A, §
470Y.

Occurred: Ch. 703, Acts of 1988. Correction by the
Michie Company in the 1988 Cumulative Supplement to
the 1986 Replacement Volume of Volume 5 of the
Annotated Code of Maryland is validated by this Act.

477E.

(a) Every hospital or major medical insurance policy or
certificate written on an expense-incurred basis which is
[delivered] DELIVERED, or issued for delivery, within this State
must include benefits for expenses arising from treatment of
acute mental illnesses and emotional disorders which in the
professional judgment of practitioners are subject to significant
improvement through short-term therapy. These benefits must be at
least equal to the following minimum requirements:

(1) With respect to benefits for confinement as an
inpatient in a hospital, the period of confinement for which

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