HARRY HUGHES, Governor                                       3873

Section 354Z, 470U, and 477AA

Annotated Code of Maryland

(1979 Replacement Volume and 1985 Supplement)

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:

Article 48A - Insurance Code

361H.

ON RECEIPT OF A PHYSICIAN'S CLAIM FOR PAYMENT OF BENEFITS
UNDER A NONPROFIT HEALTH SERVICE PLAN, THE INSURER SHALL PROMPTLY
DELIVER TO THE PHYSICIAN A PERIODIC INTERIM PAYMENT OF NOT LESS
THAN 80 PERCENT OF 80 PERCENT OF THE FULL AMOUNT CLAIMED.

470Y.

ON RECEIPT OF A PHYSICIAN'S CLAIM FOR PAYMENT OF BENEFITS
UNDER AN INDIVIDUAL HEALTH INSURANCE POLICY, THE INSURER SHALL
PROMPTLY DELIVER TO THE PHYSICIAN A PERIODIC INTERIM PAYMENT OF
NOT LESS THAN 80 PERCENT OF 80 PERCENT OF THE FULL AMOUNT
CLAIMED.

477GG.

ON RECEIPT OF A PHYSICIAN'S CLAIM FOR PAYMENT OF BENEFITS
UNDER A GROUP OR BLANKET HEALTH INSURANCE POLICY, THE INSURER
SHALL PROMPTLY DELIVER TO THE PHYSICIAN A PERIODIC INTERIM
PAYMENT OF NOT LESS THAN 80 PERCENT OF 80 PERCENT OF THE FULL
AMOUNT CLAIMED.

354Z.

(a) Notwithstanding any provision of a group or individual
policy or contract issued by a nonprofit health service plan, 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 PROVISION OF THIS
ARTICLE, WHENEVER LIABILITY AND AMOUNT ARE REASONABLY CLEAR, A
NONPROFIT HEALTH SERVICE PLAN 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