Md. Code, Insurance § 15-819
This is the official text of Md. Code, Insurance § 15-819, part of Maryland’s Code, Insurance — regulates insurance companies and the policies they sell.
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§15–819.
Official statutory text
(a) This section applies to:
(1) each individual, group, or blanket health insurance policy that is issued or delivered in the State by an insurer; and
(2) each contract or certificate that is issued or delivered in the State by a nonprofit health service plan.
(b) A policy, contract, or certificate subject to this section that provides coverage for an inpatient service in an acute general hospital shall provide coverage for:
(1) a corresponding outpatient service that is provided to the insured instead of the inpatient service because of the denial, after review under a utilization review program, of a request by the attending physician for an inpatient admission; and
(2) an objective second opinion given to the insured when required by a utilization review program under § 19-319 of the Health - General Article.
(1) each individual, group, or blanket health insurance policy that is issued or delivered in the State by an insurer; and
(2) each contract or certificate that is issued or delivered in the State by a nonprofit health service plan.
(b) A policy, contract, or certificate subject to this section that provides coverage for an inpatient service in an acute general hospital shall provide coverage for:
(1) a corresponding outpatient service that is provided to the insured instead of the inpatient service because of the denial, after review under a utilization review program, of a request by the attending physician for an inpatient admission; and
(2) an objective second opinion given to the insured when required by a utilization review program under § 19-319 of the Health - General Article.
Status: in_force · Read it on the official government site
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