HARRY HUGHES, Governor                                      2797

or group policy, contract, or certificate within this State
to reimburse certain persons within a certain period of time
after a claim is filed; providing for the payment of certain
interest if an insurer fails to comply with this Act;
providing for the amount of interest; providing for certain
exceptions; and generally relating to the payment of health
insurance claims.

BY repealing and reenacting, with amendments,

Article 48A - Insurance Code

Section 354Z, 470U, and 477AA

Annotated Code of Maryland

(1979 Replacement Volume and 1985 Supplement)

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:

Article 48A - Insurance Code

354Z.

(a) Notwithstanding any provision of a group or individual
policy or contract issued by a nonprofit health service plan, or
any certificate issued thereunder, of health, sickness, accident,
or disability insurance, delivered or issued for delivery within
the State, whenever such policy, contract, or certificate
provides for reimbursement for any service which is within the
lawful scope of practice of a health care provider duly licensed
under the Health Occupations Article, the insured, or any other
person covered by, OR ENTITLED TO REIMBURSEMENT UNDER, the
policy, contract, of certificate, shall be entitled to
reimbursement for such service. The provisions of this section
apply to all such policies, contracts, or certificates issued,
renewed, modified, altered, amended, or reissued on or after July
1, 1984.

(B) (1) NOTWITHSTANDING ANY OTHER PROVISION OF THIS
ARTICLE, WHENEVER LIABILITY IS AND AMOUNT ARE REASONABLY CLEAR, A
NONPROFIT HEALTH SERVICE PLAN SHALL REIMBURSE ANY PERSON ENTITLED
TO REIMBURSEMENT UNDER SUBSECTION (A) OF THIS SECTION OR ANY
HOSPITAL OR RELATED INSTITUTION DEFINED IN § 19-301 OF THE HEALTH
- GENERAL ARTICLE ENTITLED TO REIMBURSEMENT WITHIN 30 DAYS OF THE
PROPER FILING OF A CLAIM TOGETHER WITH ALL NECESSARY
DOCUMENTATION.

(2) (I) IF A NONPROFIT HEALTH SERVICE PLAN FAILS TO
COMPLY WITH PARAGRAPH (1) OF THIS SUBSECTION, THE NONPROFIT
HEALTH SERVICE PLAN SHALL PAY INTEREST ON THAT AMOUNT OF THE
CLAIM THAT REMAINS UNPAID 30 DAYS AFTER THE FILING OF THE CLAIM.

(II) THE INTEREST PAID UNDER THIS PARAGRAPH
SHALL BE AT THE RATE OF 1 1/2 PERCENT PER MONTH.