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ROBERT L. EHRLICH, JR., Governor
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Ch. 597
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CHAPTER 597
(House Bill 1003)
AN ACT concerning
Health Insurance - Carrier Provider Panels - Participation by Providers
FOR the purpose of requiring a health insurance carrier that uses a provider panel to
maintain standards in accordance with certain regulations if the carrier is an
insurer, nonprofit health service plan, or dental plan organization: requiring a
health insurance carrier that uses a provider panel to adhere to certain
standards for accessibility of covered services if the carrier is a health
maintenance organization: requiring a health insurance carrier that uses a
provider panel to establish procedures to verify with each provider on the
carrier's provider panel, at a certain time certain times, whether the provider is
accepting new patients and to promptly update certain information on
participating providers; requiring the carrier to establish procedures to ensure
that there is a sufficient number of certain providers on the carrier's provider
panel to guarantee certain access by an enrollee to covered services; providing
that it is an unfair trade practice under certain provisions of law for a carrier to
fail to accurately maintain and provide certain information to enrollees or to fail
to maintain a certain number of providers on the carrier's provider panel;
providing that certain provisions of this Act may not be construed to require a
carrier to allow a provider to take a certain action; requiring a carrier to update
certain provider information within a certain time period; altering the procedure
for referral to a specialist who is not part of a carrier's provider panel; requiring
a carrier to treat a certain service in a certain manner, for certain purposes;
altering a certain definition; requiring the Maryland Insurance Administration,
in consultation with certain parties, to adopt certain regulations on or before a
certain date, and to take into consideration certain standards and procedures in
adopting the regulations, requiring certain insurers, nonprofit health service
plans, and dental plan organizations to comply with the regulations on or before
a certain date: requiring the Administration, on or before a certain date, to
conduct a certain study and report on the findings and recommendations of its
study to certain legislative committees; and generally relating to health
insurance carrier provider panels.
BY repealing and reenacting, with amendments,
Article - Insurance
Section 15-112(b) and (j) and 15-830
Annotated Code of Maryland
(2002 Replacement Volume and 2005 Supplement)
BY adding to
Article - Insurance
Section 15-112(m)
Annotated Code of Maryland
- 2821-
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