termination of coverage for that individual has been received by the carrier; and
generally relating to coverage determinations by insurers and retroactive
adverse decisions based on such determinations.

BY repealing and reenacting, with amendments,
Article - Insurance
Section 15-10B-07(c)

Annotated Code of Maryland 

(1997 Volume and 1998 Supplement)

BY adding to

Article - Insurance
Section 15-303(f)
Annotated Code of Maryland

(1997 Replacement Volume and 1998 Supplement)

BY adding to 

Article - Health - General
Section 19-706(ff)
Annotated Code of Maryland

(1996 Replacement Volume and 1998 Supplement)

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

Article - Insurance

15-303.

(F) EACH POLICY OF GROUP HEALTH INSURANCE SHALL CONTAIN A
PROVISION THAT REQUIRES THE EMPLOYER LABOR UNION, ASSOCIATION, OR
OTHER ENTITY TO WHICH A POLICY OF GROUP HEALTH INSURANCE HAS BEEN
ISSUED TO CONTINUE TO PAY THE PREMIUM FOR AN EMPLOYEE, MEMBER OR
DEPENDENT UNDER THE POLICY UNTIL NOTICE OF TERMINATION OF COVERAGE
HAS BEEN RECEIVED BY THE INSURER.

15-10B-07.

(c) (1) Except as provided in paragraph (2) of this subsection, if a course of
treatment has been preauthorized or approved for a patient, a private review agent
may not retrospectively render an adverse decision regarding the preauthorized or
approved services delivered to that patient.

(2) A private review agent may retrospectively render an adverse
decision regarding preauthorized or approved services delivered to a patient if:

(i) [the patient, on the date the services were rendered, was not
insured by or an enrollee, subscriber, or member of the entity that the private review
agent is affiliated with, under contract with, or acting on behalf of;