|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PARRIS N. GLENDENING, Governor
|
|
H.B. 323
|
|
|
|
|
|
|
|
|
|
|
|
|
|
health care provider sufficient information regarding the coding guidelines used by
the carrier at least 30 days prior to the date the services subject to the retroactive
denial were rendered; OR
(III) THE CLAIM SUBMITTED TO THE CARRIER WAS A DUPLICATE
CLAIM.
(2) Information submitted to the carrier may be considered to be
improperly coded under paragraph (1) of this subsection if the information submitted
to the carrier by the health care provider:
(i) uses codes that do not conform with the coding guidelines used
by the carrier applicable as of the date the service or services were rendered; or
(ii) does not otherwise conform with the contractual obligations of
the health care provider to the carrier applicable as of the date the service or services
were rendered.
(e) (F) If a carrier retroactively denies reimbursement for services as a
result of coordination of benefits under provisions of subsection (b)(1)(i) (C)(I)(I) of this
section, the health care provider shall have 6 months from the date of denial, unless
a carrier permits a longer time period, to submit a claim for reimbursement for the
service to the carrier, Maryland Medical Assistance Program, or Medicare Program
responsible for payment.
(F) A HEALTH CARE PROVIDER MAY ENFORCE THE PROVISIONS OF THIS
SECTION BY FILING A COMPLAINT WITH THE ADMINISTRATION OR BY FILING A CIVIL
ACTION IN A COURT OF COMPETENT JURISDICTION UNDER § 1-501 OR § 4-201 OF THE
COURTS ARTICLE.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act applies to
retroactive denials of reimbursement made on or after October 1, 2000.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act applies to
retroactive denials of reimbursement made on or after October 1, 2000.
SECTION 2. 3. 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take
effect October 1, 2000.
|
|
|
|
|
|
|
|
|
|
May 18, 2000
The Honorable Casper R. Taylor, Jr.
Speaker of the House
State House
Annapolis MD 21401
Dear Mr. Speaker:
In accordance with Article II, Section 17 of the Maryland Constitution, I have today
vetoed House Bill 323 - Baltimore City - Community Benefits Districts - Review by
Mayor and City Council.
This bill repeals the General Assembly's authority to review the desirability of
|
|
|
|
|
|
|
|
|
|
- 4389 -
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
 |
