1. A. The plan excludes mandated benefits, except for Insurance Article, §§15-123(d), 15-401, 15-407, 15-408, 15-409, 15-412(a) and (h), 15-414, 15-604, 15-701, 15-811, 15-812, 15-815, 15-816, and 15-10B-09, Annotated Code of Maryland, and Health-General Article, §§19-703(d) and (g), and 19-706(h), Annotated Code of Maryland, to the extent those sections are considered mandated benefits.
2. B. This chapter does not exclude any requirement contained in statute or regulation that a carrier shall pay hospitals for hospital services rendered in accordance with rates approved by the Health Services Cost Review Commission.

3. C. Referrals to Specialists. Each carrier:

   1. (1) That does not allow direct access to specialists shall provide for a standing referral to a specialist under the requirements of Insurance Article, §15-830, Annotated Code of Maryland;
   2. (2) Shall provide for a referral to a specialist who is not part of the carrier's panel under the requirements of Insurance Article, §15-830, Annotated Code of Maryland; and
   3. (3) Shall provide direct access to obstetric and gynecological care as specified in Insurance Article, §15-816, Annotated Code of Maryland.

Authority: Health-General Article, §§19-103(c)(6) and 19-108; Insurance Article, §§2-108, 2-109, and 15-1207; Annotated Code of Maryland

Effective date: April 11, 2005 (32:7 Md. R. 686)

Regulation .03A amended as an emergency provision effective June 17, 2005 (32:14 Md. R. 1274); amended permanently effective October 10, 2005 (32:20 Md. R. 1657)

Regulation .04C amended as an emergency provision effective June 17, 2005 (32:14 Md. R. 1274); amended permanently effective October 10, 2005 (32:20 Md. R. 1657)