(a) In this section, “carrier” means:
(1) A health insurer;
(2) A nonprofit health service plan;
(3) A health maintenance organization;
(4) A dental plan organization; and
(5) Any other person included as a third party in § 1902(a)(25)(A) of the Social Security Act, as amended by the federal Deficit Reduction Act of 2005.
(b) (1) A carrier shall provide, at the request of the Department, information about individuals who are eligible for benefits under the Program or are Program recipients so that the Department may determine whether an individual, the spouse of an individual, or the dependent of an individual is receiving health care coverage from a carrier and the nature of that coverage.
(2) A carrier shall provide the information required under this subsection in a manner prescribed by the Department.
(c) A carrier shall accept the Program’s right of recovery and the assignment to the Program of any right of an individual or other entity to payment from the carrier for an item or service for which payment has been made under the Program if the carrier has a legal obligation to make payment for the item or service.
(d) As a condition of doing business in the State, a carrier shall comply with the requirements set forth in § 42 U.S.C. 1396a(a)(25)(I)(i) through (iv).
(e) A carrier subject to this section may not reject, deny, limit, cancel, refuse to renew, increase the rates of, affect the terms or conditions of, or otherwise affect a health insurance policy or contract for a reason based wholly or partly on:
(1) The eligibility of the individual for receiving benefits under the Program; or
(2) The receipt by an individual of benefits under the Program.
Structure Maryland Statutes
Title 15 - Assistance Programs
Subtitle 1 - Medical and Pharmacy Assistance Programs
Section 15-101.1 - Applicability of Other Provisions to a Managed Care Organization
Section 15-102.1 - Indigent and Medically Indigent -- Comprehensive System of Health Care
Section 15-102.2 - Applicability of Certain Provisions -- Claims of Subrogation
Section 15-102.4 - Surplus Requirements
Section 15-102.5 - Mechanism to Provide for Equitable Distribution of Enrollees
Section 15-102.6 - Applicability of Other Provisions; Regulations
Section 15-102.7 - Applicability of Certain Premium Tax Provisions
Section 15-103 - Medical Assistance Program
Section 15-103.1 - Promotion of Cost Effectiveness of State Health Care System
Section 15-103.2 - Rfps for Comparing Performance and Cost of Different Managed Care Dental Programs
Section 15-103.3 - Healthchoice Performance Incentive Fund
Section 15-103.4 - Credentialing of Health Care Providers
Section 15-103.5 - Rate Review and Comparison; Reports
Section 15-104 - Contracts With Department of Human Services
Section 15-105 - Reimbursement Procedures Under Program
Section 15-105.1 - Reimbursement Procedures Under Program -- Electronic Reimbursement
Section 15-105.2 - Reimbursement to Health Care Providers
Section 15-106 - Review of Health Care Under Program
Section 15-107 - Cost Reports of Program Participants
Section 15-108 - Field Verification of Program Participants
Section 15-109 - Eligibility; Admissibility of Long-Term Care Transaction Forms
Section 15-109.1 - Plan for Dissemination of Advance Directive Information
Section 15-109.2 - Benefits and Services for Incarcerated or Institutionalized Individuals.
Section 15-110 - Reimbursement -- Acute General and Chronic Care Hospitals
Section 15-111 - Reimbursement -- Day Care for the Elderly and Medically Handicapped Adults
Section 15-112 - Reimbursement -- Physicians
Section 15-113 - Reimbursement -- Public Institutions
Section 15-114 - Reimbursement -- Related Institutions
Section 15-114.1 - Emergency Service Transporters
Section 15-115 - Placement in Skilled or Intermediate Nursing Facility
Section 15-116 - Reimbursement -- Skilled Nursing Facilities
Section 15-117 - Reimbursement -- Reserved Beds
Section 15-118.1 - Certain Prescribed Drugs Not Specialty Drugs
Section 15-120 - Subrogation Claims
Section 15-121 - Claims Against Estates
Section 15-121.3 - Assignment of Subrogation Right
Section 15-122 - Responsibility of Spouse Under Program
Section 15-122.1 - Certain Providers Excluded From Repaying Depreciation Allowance
Section 15-122.2 - Intercepting State Tax Refund for Converted Funds
Section 15-122.3 - Personal Needs Allowance -- Disabled Person With Guardian
Section 15-124.2 - Maryland Medbank Program
Section 15-124.3 - Medicare Option Prescription Drug Program
Section 15-125 - Program for Children With Special Health Care Needs
Section 15-126 - Educational Programs for Handicapped Children
Section 15-128 - Reimbursement for Services Provided by Hospice Care Program
Section 15-129 - Durable Medical Equipment
Section 15-130.1 - Psychiatric Residential Treatment Demonstration Waiver Application
Section 15-132 - Home and Community Based Services for Impaired Individuals; Medicaid Waiver
Section 15-132.1 - Voluntary Tax Withholding
Section 15-133 - Grants to Improve Home- and Community-Based Service Systems
Section 15-134 - Maryland Medical Assistance Program Waiver
Section 15-134.1 - Military Families
Section 15-135 - Home-Based and Community Services for Residents of Nursing Facilities
Section 15-136 - Maryland Pharmacy Access Hotline
Section 15-138 - Employed Persons With Disabilities Program
Section 15-139 - Amendment of State Medical Assistance Program to Receive Federal Matching Funds
Section 15-140 - State Plan Amendment to the Family Planning Program
Section 15-141.1 - Collaborative Care Pilot Program
Section 15-141.2 - Telehealth Defined -- Pilot Program -- Outcome Data -- Reports Required
Section 15-142 - Fair Share Health Care Fund
Section 15-143 - Legal Immigrants -- Pregnant Women and Children
Section 15-145 - Information From and Liability of Health Insurance Carriers
Section 15-146 - Report -- Change to Medical Eligibility for Nursing Facility Level of Care
Section 15-147 - Former Officials or Employees -- Participation in Contracts
Section 15-148 - Prior Authorization Not Required for Contraceptive Drug or Devices