1. A. Each insurer providing Medicare supplement policies or contracts shall comply with all provisions of §4081 of the Omnibus Budget Reconciliation Act of 1987 (P.L. 100-203), and with applicable rules and regulations issued under the Act by the Secretary of the federal Department of Health and Human Services. Some of the provisions of the Act require each insurer issuing Medicare supplement policies to:

   1. (1) Agree to accept claims notices as claims for benefits under the policies;
   2. (2) Agree to make payment determination based on the information provided in the notices;
   3. (3) Provide notices to participating providers and suppliers and to the beneficiaries concerning the payment determinations;
   4. (4) Provide payment directly to participating providers and suppliers;
   5. (5) Provide Medicare beneficiaries with the name and address of Medicare contracting carriers to which notices should be sent; and
   6. (6) Agree to pay usual fees.
2. B. Each insurer shall certify on its Medicare supplement insurance experience reporting forms compliance with the requirements set forth in §A of this regulation.

Authority: Insurance Article, §2-109 and Title 15, Subtitle 9; Health-General Article, §§19-705 and 19-706; Annotated Code of Maryland

Effective date:

Regulations .01—.09, Appendixes A—C adopted as an emergency provision effective July 1, 1982 (9:13 Md. R. 1340); adopted permanently effective October 1, 1982 (9:17 Md. R. 1707)

Regulation .01 amended, Regulations .02—.09 and Appendices A—C repealed, and new Regulations .02—.14 and Appendices A—C adopted as an emergency provision effective July 25, 1989 (16:16 Md. R. 1738); emergency status extended at 16:26 Md. R. 2782 and 17:5 Md. R. 633; emergency status expired July 20, 1990

Regulation .01 amended, Regulations .02—.09 and Appendices A—C repealed, and new Regulations .02—.21 adopted effective July 23, 1990 (17:14 Md. R. 1757)

Regulation .06E adopted effective November 11, 1991 (18:22 Md. R. 2396)

Regulation .07E adopted effective November 11, 1991 (18:22 Md. R. 2396)

Regulation .16 amended effective November 11, 1991 (18:22 Md. R. 2396)

Chapter recodified from COMAR 09.30.59 to COMAR 31.10.05 effective September 7, 1998 (25:18 Md. R. 1439)

Regulation .03 amended effective January 1, 2006 (32:18 Md. R. 1522)

Regulation .07 amended effective January 1, 2006 (32:18 Md. R. 1522)

Regulation .09 amended effective January 1, 2006 (32:18 Md. R. 1522)

Regulation .11 amended effective January 1, 2006 (32:18 Md. R. 1522)

Regulations .12—.21 repealed effective January 1, 2006 (32:18 Md. R. 1522)