(a) Nonprofit health service plans are subject to Title 27 of this article.
(b) A corporation authorized under this subtitle that maintains or operates a nonprofit health service plan may not:
(1) deny a claim made under a contract, certificate, or policy of a nonprofit health service plan for an unfair or unfairly discriminatory reason;
(2) without just cause, require a person making a claim under a contract, certificate, or policy of a nonprofit health service plan to accept less than the amount due; or
(3) fail to notify in writing a subscriber or certificate holder of a nonprofit health service plan of a denial of a properly completed claim within 60 days after the plan receives the claim.
(c) If it appears to the Commissioner that an act or practice or proposed act or practice of a corporation authorized under this subtitle that maintains or operates a nonprofit health service plan is in violation of subsection (b) of this section or Title 27 of this article, the burden of persuasion is on the corporation to show that the act or practice or proposed act or practice is not in violation of subsection (b) of this section or Title 27 of this article.
Structure Maryland Statutes
Title 14 - Entities That Act as Health Insurers
Subtitle 1 - Nonprofit Health Service Plans
Part VI - Prohibited Acts; Penalties
Section 14-136 - Unfair and Discriminatory Trade Practices; Other Prohibited Acts
Section 14-137 - Exclusion of Coverage for Violations
Section 14-138 - Disclosure of Medical or Claims Information
Section 14-139 - Prohibited Acts of Officers, Directors, and Employees; Civil Penalty