Bill > HB570

This bill alters the reimbursement rate that health maintenance organizations (HMOs) are required to pay to non-participating healthcare providers for covered services. Specifically, it sets the reimbursement rate for trauma physicians at the greater of 140% of the Medicare rate or the rate paid by the HMO as of January 1, 2001. For other non-participating providers, the bill sets the reimbursement rate at the greater of 125% of the average rate the HMO paid as of January 31, 2019 (adjusted for changes in the Medicare Economic Index) or 140% of the 2008 Medicare rate (also adjusted for changes in the Medicare Economic Index). The bill also requires HMOs to disclose the reimbursement rates to non-participating providers upon request and provides a process for providers to enforce the reimbursement requirements.

Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0570?ys=2024RS