ROBERT L. EHRLICH, JR., Governor Ch. 155
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
July 1, 2004. This Act shall remain effective for a period of 1 year and 1 month and, at
the end of July 31. 2005, with no further action required by the General Assembly.
this Act shall be abrogated and of no further force and effect.
Approved April 27, 2004.
CHAPTER 155
(House Bill 123)
AN ACT concerning
Health Insurance - Prompt Payment of Claims
FOR the purpose of requiring an insurer, nonprofit health service plan, and health
maintenance organization to mail or otherwise transmit payment for a claim, or
undisputed portion of a claim, for reimbursement from certain persons within a
certain number of days after receipt of the claim or certain information relating
to the claim; and generally relating to payment of claims for reimbursement by
insurers, nonprofit health service plans, and health maintenance organizations.
BY repealing and reenacting, with amendments,
Article - Insurance
Section 15-1005
Annotated Code of Maryland
(2002 Replacement Volume and 2003 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:
Article - Insurance
15-1005.
(a) In this section, "clean claim" means a claim for reimbursement, as defined
in regulations adopted by the Commissioner under § 15-1003 of this subtitle.
(b) To the extent consistent with the Employee Retirement Income Security
Act of 1974 (ERISA), 29 U.S.C. 1001, et seq., this section applies to an insurer,
nonprofit health service plan, or health maintenance organization that acts as a third
party administrator.
(c) Within 30 days after receipt of a claim for reimbursement from a person
entitled to reimbursement under § 15-701(a) of this title or from a hospital or related
institution, as those terms are defined in § 19-301 of the Health - General Article, an
insurer, nonprofit health service plan, or health maintenance organization shall:
(1) [pay] MAIL OR OTHERWISE TRANSMIT PAYMENT FOR the claim in
accordance with this section; or
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