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Ch. 243 2007 Laws of Maryland
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the carrier's provider panel, if the termination was for reasons unrelated to fraud,
patient abuse, incompetency, or loss of licensure status;
3. notify primary care providers on the carrier's provider
panel of the termination of a specialty referral services provider:
4. verify with each provider on the carrier's provider
panel, at the time of credentialing and recredentialing, whether the provider is
accepting new patients and update the information on participating providers that the
carrier is required to provide under subsection (j) of this section: and
5. notify a provider at least 90 days before the date of
the termination of the provider from the carrier's provider panel, if the termination is
for reasons unrelated to fraud, patient abuse, incompetency, or loss of licensure status.
15-1104.
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE
MEANINGS INDICATED.
(2) "EMPLOYER SPONSORED HEALTH BENEFIT PLAN" MEANS ANY
PLAN, FUND, OR PROGRAM THAT:
(I) IS ESTABLISHED OR MAINTAINED BY AN EMPLOYER
UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974;
(II) OFFERS COVERAGE FOR HEALTH BENEFITS; AND
(III) IS TREATED BY THE EMPLOYER OR ANY ELIGIBLE
EMPLOYEE OR DEPENDENT AS PART OF A PLAN, FUND, OR PROGRAM UNDER
THE UNITED STATES INTERNAL REVENUE CODE, 26 U.S.C. § 106, § 125, OR §
162.
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(3) "GROUP HEALTH INSURANCE" HAS THE MEANING STATED IN §
15-302 OF THIS TITLE.
(4) "LIMITED BENEFIT GROUP HEALTH INSURANCE CONTRACT"
MEANS A GROUP HEALTH INSURANCE CONTRACT THAT PROVIDES HEALTH
INSURANCE BENEFITS, BUT IS NOT REQUIRED TO PROVIDE ALL THE BENEFITS
REQUIRED UNDER SUBTITLES 7 AND 8 OF THIS TITLE.
(5) "SPECIAL ELIGIBLE EMPLOYEE" MEANS AN EMPLOYEE WHO:
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