THE CODING GUIDELINES USED BY THE CARRIER AT LEAST 30 DAYS PRIOR TO THE
DATE THE SERVICES SUBJECT TO THE RETROACTIVE DENIAL WERE RENDERED.

(2) INFORMATION SUBMITTED TO A CARRIER MAY BE CONSIDERED TO
BE IMPROPERLY CODED UNDER PARAGRAPH (1) OF THIS SUBSECTION IF THE
INFORMATION SUBMITTED TO THE CARRIER BY THE HEALTH CARE PROVIDER:

(I) USES CODES THAT DO NOT CONFORM WITH THE CODING
GUIDELINES USED BY THE CARRIER APPLICABLE AS OF THE DATE THE SERVICE OR
SERVICES WERE RENDERED: OR

(II) DOES NOT OTHERWISE CONFORM WITH THE CONTRACTUAL
OBLIGATIONS OF THE HEALTH CARE PROVIDER TO THE CARRIER APPLICABLE AS OF
THE DATE THE SERVICE OR SERVICES WERE RENDERED.

(e) If a carrier retroactively denies reimbursement for services as a result of
coordination of benefits under provisions of subsection (b)(l)(i) of this section, the
health care provider shall have 6 months from the date of denial, unless a carrier
permits a longer time period, to submit a claim for reimbursement for the service to
the carrier, Maryland Medical Assistance Program, or Medicare Program responsible
for payment.

SECTION 2. AND IT BE FURTHER ENACTED. That this Act shall apply to a
retroactive denial based on improper coding issued on or after October 1, 1999
January 1, 2000, regardless of the date of the service subject to the retroactive denial.

SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take
effect October 1, 1999 January 1, 2000.

May 27, 1999

The Honorable Casper R. Taylor, Jr.
Speaker of the House
State House
Annapolis MD 21401

Dear Mr. Speaker:

In accordance with Article II, Section 17 of the Maryland Constitution, I have today
vetoed House Bill 359.

This bill alters the requirements for a certain disclosure statement furnished by a
continuing care provider. It also requires a provider to annually furnish the revised
disclosure statement to each subscriber and ensures that each subscriber initials the
revised disclosure statement.

Senate Bill 145, which was passed by the General Assembly and signed by me on May
27, 1999, accomplishes the same purpose. Therefore, it is not necessary for me to sign
House Bill 359.

Sincerely,