2018 Maryland Code
Insurance
Title 15 - Health Insurance
Subtitle 1 - General Provisions
§ 15-112.3. Multi-carrier common online provider directory information system.
(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.