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Session Laws, 1986
Volume 768, Page 2798   View pdf image
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2798

LAWS OF MARYLAND

Ch. 734

(3) THE PROVISIONS OF THIS SUBSECTION DO NOT APPLY TO
CLAIMS WITH RESPECT TO WHICH THERE IS A GOOD FAITH DISPUTE
REGARDING THE LEGITIMACY OF THE CLAIM OR THE APPROPRIATE AMOUNT
OF REIMBURSEMENT.

[(b)] (C) Notwithstanding the provisions of subsection (a)
of this section, unless the policy, contract, or certificate
expressly provides for reimbursement for any service which is
within the lawful scope of practice of a dietitian licensed under
the Health Occupations Article, the provisions of Title 4.5 of
the Health Occupations Article governing the licensing and
regulation of dietitians may not be construed to entitle the
insured or any other person covered by the policy, contract, or
certificate to reimbursement for any service which is within the
lawful scope of practice of a licensed dietitian.

[(c)] (D) Notwithstanding the provisions of subsection (a)
of this section, unless the policy, contract, or certificate
expressly provides for reimbursement for any service which is
within the lawful scope of practice of a professional counselor
certified under the Health Occupations Article, the provisions of
Title 15.5 of the Health Occupations Article governing the
certification and regulation of professional counselors may not
be construed to entitle the insured or any other person covered
by the policy, contract, or certificate to reimbursement for any
service which is within the lawful scope of practice of a
certified professional counselor.

470U.

(a) Notwithstanding any provision of a group or individual
policy or contract, including profit and nonprofit health plans,
or any certificate issued thereunder, of health, sickness,
accident, or disability insurance, delivered or issued for
delivery within the State, whenever such policy, contract, or
certificate provides for reimbursement for any service which is
within the lawful scope of practice of a health care provider
duly licensed under the Health Occupations Article, the insured,
or any other person covered by, OR ENTITLED TO REIMBURSEMENT
UNDER, the policy, contract, or certificate, shall be entitled to
reimbursement for such service. The provisions of this section
apply to all such policies, contracts, or certificates issued,
renewed, modified, altered, amended, or reissued on or after July
1, 1984.

(B) (1) NOTWITHSTANDING ANY OTHER SECTION OF THIS ARTICLE,
WHENEVER LIABILITY IS AND AMOUNT ARE REASONABLY CLEAR, AN INSURER
SHALL REIMBURSE ANY PERSON ENTITLED TO REIMBURSEMENT UNDER
SUBSECTION (A) OF THIS SECTION OR ANY HOSPITAL OR RELATED
INSTITUTION DEFINED IN § 19-301 OF THE HEALTH - GENERAL ARTICLE
ENTITLED TO REIMBURSEMENT WITHIN 30 DAYS OF THE PROPER FILING OF
A CLAIM TOGETHER WITH ALL NECESSARY DOCUMENTATION.

(2) (I) IF AN INSURER FAILS TO COMPLY WITH PARAGRAPH
(1) OF THIS SUBSECTION, THE INSURER SHALL PAY INTEREST ON THE

 

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Session Laws, 1986
Volume 768, Page 2798   View pdf image
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