Ch. 35

1997 LAWS OF MARYLAND

In subsection (a)(1)(i) of this section, the reference to a policy, contract, or
certificate that is delivered or issued for delivery in the State by "an insurer"
is added to clarify the applicability of subsection (a) of this section.

In subsection (a)(1)(ii) of this section, the former references to a policy,
contract, or certificate that is "modified" or "altered" are deleted as included
in the reference to a policy, contract, or certificate that is "amended".

In subsections (a)(2) and (b) of this section, the former references to a "duly"
licensed health care provider are deleted as implicit in the concept of
licensure.

In subsection (b) of this section, the former reference to "any form for
payment under" an individual or group disability insurance policy or contract
is deleted for accuracy since there is no form for payment that is separate from
the policy or contract.

Defined terms: "Health insurance" § 1-101
"Insurer" § 1-101
"Person" § 1-101
"Policy" § 1-101

15-702. DENTISTS, PHYSICIANS, AND PODIATRISTS UNDER SELF-FUNDED GROUP
INSURANCE PLANS.

(A) SCOPE OF SECTION.

THIS SECTION APPLIES TO EACH SELF-FUNDED GROUP INSURANCE PLAN

THAT:

(1) (I) IS FORMED BY AN ORDER, SOCIETY, OR ASSOCIATION THAT IS
INCORPORATED OR HAS A MAIN OFFICE IN THE STATE; OR

(II) COVERS INDIVIDUALS WHO RESIDE OR WORK IN THE STATE;

AND

(2) IS ISSUED, RENEWED, AMENDED, OR REISSUED ON OR AFTER JULY

1, 1972.

(B) REIMBURSEMENT FOR SERVICES.

NOTWITHSTANDING ANY OTHER PROVISION OF A SELF-FUNDED GROUP
INSURANCE PLAN SUBJECT TO THIS SECTION, IF THE PLAN PROVIDES FOR
REIMBURSEMENT FOR A SERVICE THAT IS WITHIN THE LAWFUL SCOPE OF
PRACTICE OF A PHYSICIAN, DENTIST, OR PODIATRIST, THE PLAN MAY NOT PROHIBIT
A PERSON COVERED BY THE PLAN FROM BEING REIMBURSED FOR THE SERVICE
REGARDLESS OF WHETHER THE SERVICE IS PERFORMED BY A PHYSICIAN, DENTIST,
OR PODIATRIST.

REVISOR'S NOTE: This section is new language derived without substantive
change from former Art. 48A, § 490 1/2.

In subsection (a)(1)(ii) of this section, the reference to "individuals" who

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