Matricciani, Cheryl F.

English

University of Baltimore School of Law

University of Baltimore Law ForumVolume 29Number 2 Spring/Summer 1999 Article 301999Recent Developments: House Bill 139: PatientProtection ActCheryl F. MatriccianiFollow this and additional works at: http://scholarworks.law.ubalt.edu/lfPart of the Law CommonsThis Article is brought to you for free and open access by ScholarWorks@University of Baltimore School of Law. It has been accepted for inclusion inUniversity of Baltimore Law Forum by an authorized editor of ScholarWorks@University of Baltimore School of Law. For more information, pleasecontact snolan@ubalt.edu.Recommended CitationMatricciani, Cheryl F. (1999) "Recent Developments: House Bill 139: Patient Protection Act," University of Baltimore Law Forum: Vol.29 : No. 2 , Article 30.Available at: http://scholarworks.law.ubalt.edu/lf/vol29/iss2/30Recent Developments HOUSE BILL 139: PATIENT PROTECTION ACT By Cheryl F. Matricciani H ouse Bill 139 repeals and reenacts, with amendments, the Maryland Annotated Code, Insurance Article, Section 15-113. Specifically, the Bill requires an insurer, nonprofit health service plan, HMO, dental plan, or any other person that provides health benefit plans subject to State regulation to adopt reimbursement schedules that the carrier must adhere to when paying health care providers. Furthennore, a carrier cannot adopt a reimbursement schedule that reduces the amount of reimbursement to a health care provider based on the number or cost of medical services proposed or recommended by the health care provider. Bonuses and other incentive-based compensation to health care providers is allowed if the bonus does not deter the delivery of medically appropriate care to the enrollee. Finally, the Bill requires the carrier to provide a copy of the carrier's reimbursement schedule (1) with any new contract offered to health care practitioners who do not have a contract with the carrier, (2) once a year, at the request of a health care practitioner with whom the carrier has a contract to provider services, and (3) ninety days before any proposed change in the reimbursement schedule or in the methodology used to determine bonuses or other incentive-based compensation. The Maryland Insurance Administration may adopt regulations to carry out the requirements of the Bill. This Bill will take effect on January 1, 2000. 29.2 U. Bait L.F. 92 

Recent Developments: House Bill 139: Patient Protection Act

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Recent Developments: House Bill 139: Patient Protection Act

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