Maryland Health - General Section 19-350.1

Article - Health - General

§ 19-350.1.

      (a)      (1)      In this section the following words have the meanings indicated.

            (2)      "Third party payor" means any person that administers or provides reimbursement for hospital benefits on an expense incurred basis including:

                  (i)      A health maintenance organization issued a certificate of authority in accordance with Subtitle 7 of this title;

                  (ii)      A health insurer or nonprofit health service plan authorized to offer health insurance policies or contracts in this State in accordance with the Insurance Article; or

                  (iii)      A third party administrator registered under the Insurance Article.

            (3)      "Uniform claims form" means the claim or billing form for reimbursement of hospital services adopted by the Insurance Commissioner under § 15-1003 of the Insurance Article.

      (b)      When submitting a claim or bill for reimbursement to a third party payor, a hospital shall use the uniform claims form.

      (c)      The uniform claims form submitted under this section:

            (1)      Shall be properly completed; and

            (2)      May be submitted by electronic transfer.

      (d)      The Secretary may impose a penalty not to exceed $500 on any hospital that violates the provisions of this section.



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