(a) (1) In this section the following words have the meanings indicated.
(2) (i) “Carrier” has the meaning stated in § 15–112 of this subtitle.
(ii) “Carrier” does not include a managed care organization, as defined in Title 15, Subtitle 1 of the Health – General Article.
(3) “Multi–carrier common online provider directory information system” means the system designated by the Commissioner for use by providers to provide and update their network directory information with carriers.
(b) The Commissioner may designate a multi–carrier common online provider directory information system developed by a nonprofit alliance of health plans and trade associations if:
(1) the system is available to providers nationally;
(2) the system is available to providers at no charge;
(3) the system allows providers to:
(i) attest online to the accuracy of their information; and
(ii) 1. correct any inaccurate information; and
2. attest to the correction; and
(4) the nonprofit alliance has a well–established mechanism for outreach to providers.
(c) A carrier shall accept new and updated network directory information for a provider submitted:
(1) (i) through the multi–carrier common online provider directory information system; or
(ii) directly to the carrier; and
(2) from:
(i) the provider;
(ii) a hospital or academic medical center that:
1. is a participating provider on the carrier’s provider panel; and
2. acts as a credentialing intermediary for the carrier for providers that:
A. participate on the carrier’s provider panel; and
B. have privileges at the hospital or academic medical center; or
(iii) any other person that performs credentialing functions on behalf of a provider.
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