PARRIS N. GLENDENING, Governor

Ch. 35

(1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.

(2) "CARRIER" MEANS:

(I) AN INSURER;

(II) A NONPROFIT HEALTH SERVICE PLAN;

(III) A HEALTH MAINTENANCE ORGANIZATION;

(IV) A DENTAL PLAN ORGANIZATION; OR

(V) ANY OTHER PERSON THAT PROVIDES HEALTH BENEFIT PLANS
SUBJECT TO REGULATION BY THE STATE.

(3) "HEALTH CARE PROVIDER" MEANS AN INDIVIDUAL WHO IS
LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED UNDER THE HEALTH
OCCUPATIONS ARTICLE TO PROVIDE HEALTH CARE SERVICES.

(B) LIMITATION PROHIBITED.

A CARRIER, AS A CONDITION OF A CONTRACT WITH A HEALTH CARE
PROVIDER OR IN ANY OTHER MANNER, MAY NOT PROHIBIT A HEALTH CARE
PROVIDER FROM DISCUSSING WITH OR COMMUNICATING TO AN ENROLLEE,
SUBSCRIBER, PUBLIC OFFICIAL, OR OTHER PERSON INFORMATION THAT IS
NECESSARY OR APPROPRIATE FOR THE DELIVERY OF HEALTH CARE SERVICES,
INCLUDING:

(1) COMMUNICATIONS THAT RELATE TO TREATMENT ALTERNATIVES;

(2) COMMUNICATIONS THAT ARE NECESSARY OR APPROPRIATE TO
MAINTAIN THE PROVIDER-PATIENT RELATIONSHIP WHILE THE PATIENT IS UNDER
THE HEALTH CARE PROVIDER'S CARE;

(3) COMMUNICATIONS THAT RELATE TO AN ENROLLEE'S OR
SUBSCRIBER'S RIGHT TO APPEAL A COVERAGE DETERMINATION OF A CARRIER
WITH WHICH THE HEALTH CARE PROVIDER, ENROLLEE, OR SUBSCRIBER DOES NOT
AGREE; AND

(4) OPINIONS AND THE BASIS OF AN OPINION ABOUT PUBLIC POLICY

ISSUES.

(C) EFFECT OF SECTION.

THIS SECTION DOES NOT PROHIBIT A CARRIER, AS A CONDITION OF A
CONTRACT BETWEEN THE CARRIER AND A HEALTH CARE PROVIDER, FROM
PROHIBITING TORTIOUS INTERFERENCE WITH A CONTRACT AS RECOGNIZED
UNDER STATE LAW.

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

In subsection (a)(2)(v) of this section, the former reference to an

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