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Maryland Code, Insurance § 15-819

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(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.

Cite this article: - Maryland Code, Insurance § 15-819 - last updated December 31, 2021 |

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