§ 15-1A-14. Emergency services
West's Annotated Code of MarylandInsuranceEffective: May 8, 2020
Effective: May 8, 2020
MD Code, Insurance, § 15-1A-14
§ 15-1A-14. Emergency services
(2) “Emergency medical condition” means a medical condition that manifests itself by acute symptoms of such severity, including severe pain, that the absence of immediate medical attention could reasonably be expected by a prudent layperson, who possesses an average knowledge of health and medicine, to result in a condition described in § 1867(e)(1) of the Social Security Act.
(b) If a carrier provides or covers any benefits for emergency services in an emergency department of a hospital or freestanding medical facility, the carrier:
(c) If a health care provider of emergency services does not have a contractual relationship with the carrier to provide emergency services, the carrier:
(d) Except as provided in § 14-205.2 of this article and § 19-710.1 of the Health--General Article, a carrier shall reimburse a health care provider of emergency services that does not have a contractual relationship with the carrier the greater of:
(2) the amount for the emergency service calculated using the same method the health benefit plan generally uses to determine payments for out-of-network services, excluding any in-network copayment or coinsurance, without reduction for out-of-network cost-sharing that generally applies under the health benefit plan; or
Credits
Added by Acts 2020, c. 620, § 1, eff. May 8, 2020; Acts 2020, c. 621, § 1, eff. May 8, 2020.
MD Code, Insurance, § 15-1A-14, MD INSURANCE § 15-1A-14
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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