Md. Code Regs. 31.12.04.08

Current through Register Vol. 52, No. 1, January 10, 2025

Section 31.12.04.08 - Provider Contracts

A. Each provider contract shall contain the provisions in §§B-G of this regulation.

B. A provision shall be included to require the provider to make an initial commitment to the plan of at least 12 months. The provider may not terminate the contract during this 12-month period unless the provider becomes unavailable during that initial time for reasons beyond the control of the dental plan organization or the provider.

C. Hold-Harmless Clause. A hold-harmless clause, which shall read substantially as follows is required: "The provider agrees that under no circumstances, including nonpayment by the dental plan organization, insolvency of the dental plan organization, or breach of this contract, shall provider seek payment from an enrollee for services rendered under this contract for other than a copayment listed in the dental benefit contract. Provider further agrees that this provision shall survive the termination of this provider contract regardless of the cause of the termination."

D. A provision specifying when the contract becomes effective is required.

E. A provision specifying the date the contract terminates is required.

F. A renewal provision is required.

G. A provision specifying the benefits the provider shall supply the enrollees is required, specifying that:

(1) The provider shall supply services to enrollees in exchange for the copayments specified in the dental benefit contract while the provider's provider contract is in force; and

(2) After the provider contract terminates, the provider shall continue to provide services to enrollees in accordance with Insurance Article, § 15-112, Annotated Code of Maryland.

Md. Code Regs. 31.12.04.08

Regulation .08G amended effective August 2, 2004 (31:15 Md. R. 1187)