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§ 15-125. Consent by health care provider required for carrier to assign, transfer, or subcontr...

West's Annotated Code of MarylandInsurance

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 15. Health Insurance
Subtitle 1. General Provisions (Refs & Annos)
MD Code, Insurance, § 15-125
§ 15-125. Consent by health care provider required for carrier to assign, transfer, or subcontract health care provider contracts
Currentness
Definitions
(a)(1) In this section the following words have the meanings indicated.
(2)(i) “Carrier” means:
1. an insurer;
2. a nonprofit health service plan;
3. a health maintenance organization;
4. a dental plan organization; or
5. any other person that provides health benefit plans subject to regulation by the State.
(ii) “Carrier” includes an entity that arranges a provider panel for a carrier.
(3) “Contract” means the implied or express agreement between a health care provider and carrier, including the rights, obligations, and fee schedule for the provision of health care services.
(4) “Health care provider” means an individual who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health care services.
Consent by health care provider required for carrier to assign, transfer, or subcontract health care provider contracts
(b)(1) A carrier may not in any manner assign, transfer, or subcontract a health care provider's contract, wholly or partly, to an insurer that offers personal injury protection coverage under § 19-505 of this article without first informing the health care provider and obtaining the health care provider's express written consent.
(2) A carrier may not terminate, limit, or otherwise impair the contract or employment of a health care provider with the carrier on the basis that the health care provider refused to agree to an assignment, transfer, or subcontract of all or part of the health care provider's contract to an insurer that offers personal injury protection coverage under § 19-505 of this article.
Carriers prohibited from requiring health care provider to serve on provider panel for workers’ compensation services
(c)(1) A carrier that uses a provider panel for health care services may not require a health care provider, as a condition of participation or continuation on the carrier's provider panel for health care services, to also serve on a provider panel for workers' compensation services.
(2) A carrier may not terminate, limit, or otherwise impair a contract or an agreement with a health care provider, or terminate or limit the employment of a health care provider, based on the health care provider's election not to serve on a provider panel for workers' compensation services.
(3) A carrier shall include in a contract or an agreement with a health care provider a disclosure that informs the health care provider of the right to elect not to serve on a provider panel for workers' compensation services.

Credits

Added by Acts 1998, c. 417, § 1, eff. Oct. 1, 1998. Amended by Acts 1999, c. 698, § 1, eff. June 1, 1999; Acts 2006, c. 476, § 1, eff. July 1, 2006.
MD Code, Insurance, § 15-125, MD INSURANCE § 15-125
Current through legislation effective through April 9, 2023, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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