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2017 Maryland Code
Insurance
Title 15 - Health Insurance
Subtitle 1 - General Provisions
§ 15-112.3. Multi-carrier common online provider directory information system.
Universal Citation: MD Ins Code § 15-112.3 (2017)
- (a) Definitions. --
- (1) In this section the following words have the meanings indicated.
- (2)
- (i) "Carrier" has the meaning stated in ยง 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) Prerequisites. -- 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) Requirements for acceptance of new and updated information. -- 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.
- (1) (i) through the multi-carrier common online provider directory information system; or
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