Md. Code Regs. 10.09.24.17

Current through Register Vol. 51, No. 22, November 1, 2024

Section 10.09.24.17 - Information from and Liability of Health Insurance Carriers

A. A carrier shall:

(1) Provide, at the request of the Department, information about individuals who are eligible for benefits under the Program or are Program recipients so that the Department may determine:

(a) Whether an individual, the spouse of an individual, or the dependent of an individual is receiving health care coverage from a carrier; and

(b) The nature of that coverage;

(2) Provide the information required under §A of this regulation in a manner prescribed by the Department; and

(3) Accept the Program's right of recovery and the assignment to the Program of any right of an individual or other entity to payment from the carrier for an item or service for which payment has been made under the Program if the carrier has a legal obligation to make payment for the item or service.

B. Subject to §A of this regulation, a carrier may not reject, deny, limit, cancel, refuse to renew, increase the rates of, affect the terms or conditions of, or otherwise affect a health insurance policy or contract for a reason based wholly or partly on the:

(1) Eligibility of the individual for receiving benefits under the Program; or

(2) Receipt by an individual of benefits under the Program.

C. A carrier shall comply with the provisions of Health-General Article, §15-144, Annotated Code of Maryland, pertaining to health maintenance organizations.

Md. Code Regs. 10.09.24.17

Regulation .17 adopted effective December 31, 2007 (34:26 Md. R. 2262)