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2007 Vetoed Bills and Messages
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S.B. 427
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2. if the carrier is a health maintenance organization,
adhere to the standards for accessibility of covered services in accordance with
regulations adopted under § 19-705. 1(b)(1)(ii) of the Health - General Article; and
3. IF THE CARRIER IS AN INSURER OR NONPROFIT
HEALTH SERVICE PLAN THAT OFFERS A PREFERRED PROVIDER INSURANCE
POLICY THAT CONDITIONS THE PAYMENT OF BENEFITS ON THE USE OF
PREFERRED PROVIDERS, ADHERE TO THE STANDARDS FOR ACCESSIBILITY OF
COVERED SERVICES IN ACCORDANCE WITH REGULATIONS ADOPTED UNDER §
19-705.1(B)(1)(II) OF THE HEALTH - GENERAL ARTICLE AND AS ENFORCED BY
THE SECRETARY OF HEALTH AND MENTAL HYGIENE; AND
(ii) establish procedures to:
1. review applications for participation on the carrier's
provider panel in accordance with this section;
2. notify an enrollee of:
A. the termination from the carrier's provider panel of
the primary care provider that was furnishing health care services to the enrollee; and
B. the right of the enrollee. on request, to continue to
receive health care services from the enrollee's primary care provider for up to 90 days
after the date of the notice of termination of the enrollee's primary care provider from
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.
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- 4244 -
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