§ 15-112.3

Maryland § 15-112.3

• Jurisdiction: Maryland
• Article gin: Insurance
• Title: 15

Text

(a) (1) In this section the following words have the meanings indicated.

(2) (i) “Carrier” has the meaning stated in § 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 provider directory information with carriers.

(b) 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) A carrier shall accept new and updated provider 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.