1. A. This regulation applies to carriers who receive claims for services provided by physicians who are nonpreferred providers but are not on-call physicians or hospital-based physicians.
2. B. A carrier shall permit a nonpreferred provider described in §A of this regulation to accept an assignment of benefits under a preferred provider insurance policy offered by the carrier.

3. C. Except as provided in Insurance Article, §14-205.3(g), Annotated Code of Maryland, a carrier that receives a claim for services provided by a nonpreferred provider described in §A of this regulation who accepts an assignment of benefits under a preferred provider insurance policy shall pay the nonpreferred provider directly if the nonpreferred provider:

   1. (1) Provides a copy of the disclosure set forth in Regulation .06 of this chapter to an insured before performing a health care service for the insured; and
   2. (2) Submits a copy of the signed disclosure set forth in Regulation .06 of this chapter to the carrier.

Authority: Insurance Article, §§2-109(a)(1), 14-205.2, and 14-205.3, Annotated Code of Maryland

Effective date: September 19, 2011 (38:19 Md. R. 1148)