PARRIS N. GLENDENING, Governor                             Ch. 348

AUTOMOBILE INSURANCE FUND UNDER § 243H OF THIS ARTICLE FOR ANY BENEFITS
OR PAYMENTS THAT WOULD OTHERWISE BE PAYABLE UNDER UNINSURED
MOTORIST COVERAGE.

(h) The amount of uninsured motorist coverage under a motor vehicle insurance
policy may not exceed the amount of the liability coverage under the same policy.

541A.

(A) IN THIS SECTION, THE TERMS "HEALTH CARE SERVICE" AND "HEALTH
CARE PRACTITIONER" HAVE THE MEANINGS STATED IN THE HEALTH—GENERAL
ARTICLE, § 19-1501.

(B) (1) BEGINNING JULY 1, 1997, WITH RESPECT TO HEALTH CARE SERVICES
RELATING TO SOFT TISSUE INJURIES RESULTING FROM A MOTOR VEHICLE
ACCIDENT, AN INSURER PROVIDING BENEFITS UNDER § 539 OF THIS SUBTITLE OR
PROVIDING COVERAGE UNDER § 541(A) AND (C) OF THIS SUBTITLE MAY NOT BE
REQUIRED TO PAY, AND A PERSON PROVIDING SUCH HEALTH CARE SERVICES MAY
NOT REQUIRE OR REQUEST, PAYMENT IN EXCESS OF THAT PROVIDED UNDER §
19-1509 OF THE HEALTH - GENERAL ARTICLE.

(2) IF REIMBURSEMENT FOR A HEALTH CARE SERVICE HAS NOT BEEN
ESTABLISHED BY THE SYSTEM ADOPTED UNDER § 19-1509 OF THE HEALTH -
GENERAL ARTICLE THE AMOUNT PAYABLE MAY NOT EXCEED 80% OF THE
PROVIDER'S USUAL AND CUSTOMARY CHARGE.

(3) A HEALTH CARE PRACTITIONER SUBJECT TO THIS SECTION MAY
NOT BILL THE INSURED OR INJURED PERSON, OR OTHERWISE ATTEMPT TO
COLLECT, ANY DIFFERENCE BETWEEN THE AMOUNT PAYABLE UNDER THIS
SECTION AND ANY OTHER AMOUNT CHARGED BY THE HEALTH CARE
PRACTITIONER.

(C) (1) BEGINNING JANUARY 1, 1997, ANY INSURER PAYING BENEFITS OR
CLAIMS UNDER § 539 OR PROVIDING COVERAGE UNDER § 541 OF THIS ARTICLE MAY
CONTRACT WITH A PEER REVIEW ORGANIZATION (PRO) FOR THE PURPOSE OF
EVALUATING WHETHER HEALTH CARE SERVICES FOR SOFT TISSUE INJURIES ARE:

(I) MEDICALLY NECESSARY; AND

(II) CONFORM TO PROFESSIONAL STANDARDS OF PERFORMANCE.

(2) AN INSURER'S REFERRAL OF A BILL FOR A HEALTH CARE SERVICE
MUST BE MADE TO A PRO WITHIN 90 DAYS OF THE INSURER'S RECEIPT OF THE
PRACTITIONER'S BILL, OR MAY BE MADE AT ANY TIME FOR CONTINUING HEALTH
CARE SERVICES.

(3) AN INSURER, PRACTITIONER, OR INSURED MAY REQUEST A
RECONSIDERATION BY THE PRO OF THE PRO'S INITIAL DETERMINATION. SUCH A
REQUEST FOR RECONSIDERATION MUST BE MADE WITHIN 30 DAYS OF THE PRO'S
INITIAL DETERMINATION. IF RECONSIDERATION IS REQUESTED FOR THE HEALTH

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