Md. Code, Ins. §§ 15-601 through 15-605: Required Reimbursement of Institutions – Maryland

Status: Enacted
Year Enacted: 1997
Year Amended: 2017
File: Download

Each entity subject to this section that offers benefits to an insured or beneficiary who uses designated low-cost hospitals, that are different from the benefits offered when other hospitals are used, shall base its designation of a low-cost hospital on information as required by this provision. A policy or certificate subject to this section may not exclude payments or benefits for the treatment of tuberculosis, mental illness, or another illness covered under the policy or certificate because treatment is received in a hospital or other institution of the State or of a county or municipal corporation of the State, whether or not the hospital or other institution is deemed charitable. Each authorized insurer, nonprofit health service plan, and fraternal benefit society, and each managed care organization that is authorized to receive Medicaid prepaid capitation payments shall pay hospitals for hospital services rendered on the basis of the rate approved by the Health Services Cost Review Commission; and comply with the applicable terms and conditions of Maryland’s all-payer model contract approved by the federal Center for Medicare and Medicaid Innovation. The annual report to the commissioner shall include the financial condition of the managed care organization, business plan, and loss rations. This report shall be public.


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