§ 14-104
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/md/insurance/14-104A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
§14–104.
(a)Each nonprofit health service plan that provides hospital benefits shall furnish a statement of the plan’s principal claims practices as part of the certificate form or booklet describing the coverage to be afforded.
(b)The statement shall include practices for payment for:
(1)surgical procedures performed by two or more surgeons;
(2)services provided in-area by nonparticipating providers; and
(3)services provided out-of-area by affiliated plans and affiliated providers.