Bill > HB1464

This bill requires third-party administrators, which are entities that manage health benefit plans on behalf of others, to establish a clear and efficient system for healthcare providers to check if a patient, or "enrollee," is eligible for covered health services and for the administrator to respond promptly to these inquiries. Furthermore, it prevents certain health insurance companies, referred to as "carriers," from retroactively denying payment to a provider if that provider had already confirmed the enrollee's eligibility for services through this established process, thereby protecting providers from unexpected financial losses due to eligibility errors made by the administrator.

Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB1464?ys=2026RS