(a) (1) An insurer under a contract that provides an individual with home medical equipment pursuant to an individual, group, or blanket health insurance policy or certificate that is delivered or issued for delivery in the State and that provides benefits on an expense-incurred basis:
(i) shall pay the home medical equipment provider directly if the insured has executed an assignment of benefits; and
(ii) subject to the copayment and deductible provisions in the insurance contract, may not require the home medical equipment provider to accept less than the agreed monthly rental amount for each month in which benefits are payable under the insurance contract.
(2) A nonprofit health service plan under a contract that provides a subscriber with home medical equipment pursuant to a health insurance policy or certificate that is delivered or issued for delivery in the State and that provides benefits on an expense-incurred basis:
(i) shall pay the home medical equipment provider directly if the contract, policy, or certificate of insurance provides for direct payment;
(ii) may pay the home medical equipment provider or the subscriber receiving the home medical equipment, if the contract, policy, or certificate of insurance does not require direct payment; and
(iii) may not require the home medical equipment provider to accept less than the agreed monthly rental amount for each month that use of the home medical equipment is authorized by the nonprofit health service plan.
(b) Authorization may not be terminated until both the provider and beneficiary of the home medical equipment have been notified that authorization is terminated.
(c) (1) Rented home medical equipment and services may be purchased with the consent of the provider and insurer if:
(i) on the insurer’s request either before the initial election to rent the equipment or on the insurer’s receipt of the initial claim from the provider, the purchase price and rental price of the equipment were disclosed to the insurer; and
(ii) there is no material change in the medical condition of the insured, as certified by the attending physician.
(2) Rented home medical equipment and services may be purchased with the consent of the provider and nonprofit health service plan in accordance with the benefits available under the applicable health insurance policy or certificate.
Structure Maryland Statutes
Subtitle 1 - General Provisions
Section 15-101 - Scope of Title
Section 15-102 - Third-Party Ownership of Policies
Section 15-103 - Simplified Language Required
Section 15-104 - Nonduplication and Coordination Provisions in Policies
Section 15-105 - Coverage Information About Breast Implants
Section 15-106 - Home Medical Equipment
Section 15-107 - Notice to Pharmacies of Change in Pharmaceutical Benefits
Section 15-108 - Record Keeping Procedures
Section 15-109 - Minimum Loss Ratio for Specified Disease Policies
Section 15-110 - Prohibited Referrals
Section 15-111 - Assessment of Fees on Payors
Section 15-112 - Provider Panels
Section 15-112.1 - Carriers and Credentialing Intermediaries; Uniform Credentialing Form
Section 15-112.2 - Provider Contract
Section 15-112.3 - Multi-Carrier Common Online Provider Directory Information System
Section 15-113 - Compensation of Health Care Practitioners or Set of Health Care Practitioners
Section 15-115 - Provider Participation in Managed Care Organizations
Section 15-116 - Communication of Information by Health Care Providers
Section 15-117 - Indemnification of Insurers and Nonprofit Health Service Plans
Section 15-118 - Coinsurance Payments for Health Care Services
Section 15-119 - Uniform Consultation Referral Forms -- in General
Section 15-120 - Uniform Consultation Referral Forms -- Regulations
Section 15-121 - Disclosures Required in Enrollment Sales Materials
Section 15-122 - Notice of Renewal of Health Benefit Plan
Section 15-122.1 - Disbursement of Advance Directive Information Sheet by Carriers
Section 15-123 - Emerging Medical and Surgical Treatments
Section 15-124 - Group Health Insurers -- Enrollment of Minors
Section 15-125 - Restrictions on Assigning, Transferring, or Subcontracting Contracts
Section 15-126 - Access to 911 Emergency System
Section 15-129 - Stop-Loss Insurance Policies
Section 15-130 - Health Insurance Benefit Card, Prescription Benefit Card, Etc
Section 15-130.1 - Health Insurance Benefit Cards, Prescription Benefit Cards, and Other Technology
Section 15-131 - Electronic Reimbursement
Section 15-132 - Incentives to Health Care Providers
Section 15-133 - Annual Report
Section 15-134 - Effect of Federal Patient Protection and Affordable Care Act on Maryland Plans
Section 15-135 - Covered Benefits for Annual Preventive Care
Section 15-135.1 - Dental Preventive Care Coverage
Section 15-136 - Bonus Payments to Primary Care Providers
Section 15-138 - Direct Reimbursement of Ambulance Service Provider
Section 15-139 - Coverage for Services Delivered Through Telehealth
Section 15-141 - Communications Between Carriers and Enrollees -- Confidentiality
Section 15-142 - Step Therapy or Fail-First Protocol
Section 15-143 - Compensation Agreements Arrangements Under Federally Approved Programs and Models
Section 15-145 - Definitions -- When Health Savings Account Established