MD
Maryland House Bill HB1292

Maryland 2025 Regular Session

Maryland House Bill HB1292 Compare Versions

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33 EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
44 [Brackets] indicate matter deleted from existing law.
55 Underlining indicates amendments to bill.
66 Strike out indicates matter stricken from the bill by amendment or deleted from the law by
77 amendment.
8- Italics indicate opposite chamber/conference committee amendments.
98 *hb1292*
109
1110 HOUSE BILL 1292
12-J5 (5lr3303)
13-ENROLLED BILL
14-— Health and Government Operations/Finance —
15-Introduced by Delegates Kaiser, Feldmark, Guzzone, Harrison, Hill, Kaufman, and
16-Taylor Taylor, Alston, Bagnall, Bhandari, Chisholm, Cullison, Hutchinson,
11+J5 5lr3303
12+
13+By: Delegates Kaiser, Feldmark, Guzzone, Harrison, Hill, Kaufman, and Taylor
14+Taylor, Alston, Bagnall, Bhandari, Chisholm, Cullison, Hutchinson,
1715 S. Johnson, Kerr, Kipke, Lopez, Martinez, M. Morgan, Pena–Melnyk, Reilly,
1816 Rosenberg, Ross, Szeliga, Taveras, White Holland, Woods, and Woorman
19-
20-Read and Examined by Proofreaders:
21-
22-_______________________________________________
23-Proofreader.
24-_______________________________________________
25-Proofreader.
26-
27-Sealed with the Great Seal and presented to the Governor, for his approval this
28-
29-_______ day of _______________ at _____________ ___________ o’clock, ________M.
30-
31-______________________________________________
32-Speaker.
17+Introduced and read first time: February 7, 2025
18+Assigned to: Health and Government Operations
19+Committee Report: Favorable with amendments
20+House action: Adopted
21+Read second time: March 6, 2025
3322
3423 CHAPTER ______
3524
3625 AN ACT concerning 1
3726
3827 Health Insurance – Provider Directory – Required Updates 2
3928
4029 FOR the purpose of renaming “network directory” to be “provider directory” to conform to 3
4130 a certain federal law; altering the time period within which a carrier is certain 4
4231 carriers are required to update the information that must be made available in the 5
4332 carrier’s provider directory on the Internet; requiring a carrier to verify and, as 6
4433 necessary, update the carrier’s provider directory with a certain frequency altering 7
4534 the information required to be included in a provider directory; requiring that a 8
4635 provider directory in printed form include a certain statement regarding the 9
4736 accuracy of the provider information; and generally relating to provider directories 10
4837 of health insurance carriers. 11
49- 2 HOUSE BILL 1292
38+
39+BY repealing and reenacting, with amendments, 12
40+ Article – Insurance 13
41+Section 15–112(a), (n), (p), and (t), 15–112.3(a)(3) and (c), and 15–830(g)(2)(i) 14
42+ Annotated Code of Maryland 15
43+ (2017 Replacement Volume and 2024 Supplement) 16
44+
45+BY repealing and reenacting, without amendments, 17
46+ Article – Insurance 18
47+Section 15–112.3(a)(1) 19
48+ Annotated Code of Maryland 20 2 HOUSE BILL 1292
5049
5150
52-BY repealing and reenacting, with amendments, 1
53- Article – Insurance 2
54-Section 15–112(a), (n), (p), and (t), 15–112.3(a)(3) and (c), and 15–830(g)(2)(i) 3
55- Annotated Code of Maryland 4
56- (2017 Replacement Volume and 2024 Supplement) 5
51+ (2017 Replacement Volume and 2024 Supplement) 1
5752
58-BY repealing and reenacting, without amendments, 6
59- Article – Insurance 7
60-Section 15–112.3(a)(1) 8
61- Annotated Code of Maryland 9
62- (2017 Replacement Volume and 2024 Supplement) 10
53+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 2
54+That the Laws of Maryland read as follows: 3
6355
64- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 11
65-That the Laws of Maryland read as follows: 12
56+Article – Insurance 4
6657
67-Article – Insurance 13
58+15–112. 5
6859
69-15–112. 14
60+ (a) (1) In this section the following words have the meanings indicated. 6
7061
71- (a) (1) In this section the following words have the meanings indicated. 15
62+ (2) “Accredited hospital” has the meaning stated in § 19–301 of the 7
63+Health – General Article. 8
7264
73- (2) “Accredited hospital” has the meaning stated in § 19–301 of the 16
74-Health – General Article. 17
65+ (3) “Ambulatory surgical facility” has the meaning stated in § 19–3B–01 of 9
66+the Health – General Article. 10
7567
76- (3) “Ambulatory surgical facility” has the meaning stated in § 19–3B–01 of 18
77-the Health – General Article. 19
68+ (4) “Behavioral health care services” has the meaning stated in § 15–127 11
69+of this subtitle. 12
7870
79- (4) “Behavioral health care services” has the meaning stated in § 15–127 20
80-of this subtitle. 21
71+ (5) (i) “Carrier” means: 13
8172
82- (5) (i) “Carrier” means: 22
73+ 1. an insurer; 14
8374
84- 1. an insurer; 23
75+ 2. a nonprofit health service plan; 15
8576
86- 2. a nonprofit health service plan; 24
77+ 3. a health maintenance organization; 16
8778
88- 3. a health maintenance organization; 25
79+ 4. a dental plan organization; or 17
8980
90- 4. a dental plan organization; or 26
81+ 5. any other person that provides health benefit plans 18
82+subject to regulation by the State. 19
9183
92- 5. any other person that provides health benefit plans 27
93-subject to regulation by the State. 28
84+ (ii) “Carrier” includes an entity that arranges a provider panel for a 20
85+carrier. 21
9486
95- (ii) “Carrier” includes an entity that arranges a provider panel for a 29
96-carrier. 30
87+ (6) “Credentialing intermediary” means a person to whom a carrier has 22
88+delegated credentialing or recredentialing authority and responsibility. 23
89+
90+ (7) “Enrollee” means a person entitled to health care benefits from a 24
91+carrier. 25
92+
93+ (8) “Group model health maintenance organization” has the meaning 26
94+stated in § 19–713.6(a) of the Health – General Article. 27
95+
96+ (9) “Health benefit plan”: 28
9797 HOUSE BILL 1292 3
9898
9999
100- (6) “Credentialing intermediary” means a person to whom a carrier has 1
101-delegated credentialing or recredentialing authority and responsibility. 2
100+ (i) for a group or blanket plan in the large group market, has the 1
101+meaning stated in § 15–1401 of this title; 2
102102
103- (7) “Enrollee” means a person entitled to health care benefits from a 3
104-carrier. 4
103+ (ii) for a group in the small group market, has the meaning stated in 3
104+§ 31–101 of this article; and 4
105105
106- (8) “Group model health maintenance organization” has the meaning 5
107-stated in § 19–713.6(a) of the Health – General Article. 6
106+ (iii) for an individual plan, has the meaning stated in § 15–1301 of 5
107+this title. 6
108108
109- (9) “Health benefit plan”: 7
109+ (10) (i) “Health care facility” means a health care setting or institution 7
110+providing physical, mental, or substance use disorder health care services. 8
110111
111- (i) for a group or blanket plan in the large group market, has the 8
112-meaning stated in § 15–1401 of this title; 9
112+ (ii) “Health care facility” includes: 9
113113
114- (ii) for a group in the small group market, has the meaning stated in 10
115-§ 31–101 of this article; and 11
114+ 1. a hospital; 10
116115
117- (iii) for an individual plan, has the meaning stated in § 15–1301 of 12
118-this title. 13
116+ 2. an ambulatory surgical or treatment center; 11
119117
120- (10) (i) “Health care facility” means a health care setting or institution 14
121-providing physical, mental, or substance use disorder health care services. 15
118+ 3. a skilled nursing facility; 12
122119
123- (ii) “Health care facility” includes: 16
120+ 4. a residential treatment center; 13
124121
125- 1. a hospital; 17
122+ 5. an urgent care center; 14
126123
127- 2. an ambulatory surgical or treatment center; 18
124+ 6. a diagnostic, laboratory, or imaging center; 15
128125
129- 3. a skilled nursing facility; 19
126+ 7. a rehabilitation facility; and 16
130127
131- 4. a residential treatment center; 20
128+ 8. any other therapeutic health care setting. 17
132129
133- 5. an urgent care center; 21
130+ (11) “Hospital” has the meaning stated in § 19–301 of the Health – General 18
131+Article. 19
134132
135- 6. a diagnostic, laboratory, or imaging center; 22
133+ (12) “Network” means a carrier’s participating providers and the health care 20
134+facilities with which a carrier contracts to provide health care services to the carrier’s 21
135+enrollees under the carrier’s health benefit plan. 22
136136
137- 7. a rehabilitation facility; and 23
137+ [(13) “Network directory” means a list of a carrier’s participating providers 23
138+and participating health care facilities.] 24
138139
139- 8. any other therapeutic health care setting. 24
140+ [(14)] (13) “Online credentialing system” means the system through which 25
141+a provider may access an online provider credentialing application that the Commissioner 26
142+has designated as the uniform credentialing form under § 15–112.1(e) of this subtitle. 27
140143
141- (11) “Hospital” has the meaning stated in § 19–301 of the Health – General 25
142-Article. 26
144+ [(15)] (14) “Participating provider” means a provider on a carrier’s provider 28
145+panel. 29
146+ 4 HOUSE BILL 1292
143147
144- (12) “Network” means a carrier’s participating providers and the health care 27
145-facilities with which a carrier contracts to provide health care services to the carrier’s 28
146-enrollees under the carrier’s health benefit plan. 29 4 HOUSE BILL 1292
148+
149+ [(16)] (15) “Provider” means a health care practitioner or group of health 1
150+care practitioners licensed, certified, or otherwise authorized by law to provide health care 2
151+services. 3
152+
153+ (16) “PROVIDER DIRECTORY ” MEANS A LIST OF A CA RRIER’S 4
154+PARTICIPATING PROVID ERS AND PARTICIPATIN G HEALTH CARE FACILI TIES. 5
155+
156+ (17) (i) “Provider panel” means the providers that contract either 6
157+directly or through a subcontracting entity with a carrier to provide health care services to 7
158+the carrier’s enrollees under the carrier’s health benefit plan. 8
159+
160+ (ii) “Provider panel” does not include an arrangement in which any 9
161+provider may participate solely by contracting with the carrier to provide health care 10
162+services at a discounted fee–for–service rate. 11
163+
164+ (n) (1) A carrier shall make the carrier’s [network] PROVIDER directory 12
165+available to prospective enrollees on the Internet and, on request of a prospective enrollee, 13
166+in printed form. 14
167+
168+ (2) The carrier’s [network] PROVIDER directory on the Internet shall be 15
169+available: 16
170+
171+ (i) through a clear link or tab; and 17
172+
173+ (ii) in a searchable format. 18
174+
175+ (3) The [network] PROVIDER directory shall include: 19
176+
177+ (i) for each provider on the carrier’s provider panel: 20
178+
179+ 1. the name of the provider; 21
180+
181+ 2. the specialty areas of the provider; 22
182+
183+ 3. whether the provider currently is accepting new patients; 23
184+
185+ 4. for each office of the provider where the provider 24
186+participates on the provider panel: 25
187+
188+ A. its location, including its address; and 26
189+
190+ B. contact information for the provider; 27
191+
192+ 5. the gender of the provider, if the provider notifies the 28
193+carrier or the multi–carrier common online provider directory information system 29
194+designated under § 15–112.3 of this subtitle of the information; and 30 HOUSE BILL 1292 5
147195
148196
149197
150- [(13) “Network directory” means a list of a carrier’s participating providers 1
151-and participating health care facilities.] 2
198+ 6. any languages spoken by the provider other than English, 1
199+if the provider notifies the carrier or the multi–carrier common online provider directory 2
200+information system designated under § 15–112.3 of this subtitle of the information; 3
152201
153- [(14)] (13) “Online credentialing system” means the system through which 3
154-a provider may access an online provider credentialing application that the Commissioner 4
155-has designated as the uniform credentialing form under § 15–112.1(e) of this subtitle. 5
202+ (ii) for each health care facility in the carrier’s network: 4
156203
157- [(15)] (14) “Participating provider” means a provider on a carrier’s provider 6
158-panel. 7
204+ 1. the health care facility’s name; 5
159205
160- [(16)] (15) “Provider” means a health care practitioner or group of health 8
161-care practitioners licensed, certified, or otherwise authorized by law to provide health care 9
162-services. 10
206+ 2. the health care facility’s address; 6
163207
164- (16) “PROVIDER DIRECTORY ” MEANS A LIST OF A CA RRIER’S 11
165-PARTICIPATING PROVID ERS AND PARTICIPATIN G HEALTH CARE FACILI TIES. 12
208+ 3. the types of services provided by the health care facility; 7
209+and 8
166210
167- (17) (i) “Provider panel” means the providers that contract either 13
168-directly or through a subcontracting entity with a carrier to provide health care services to 14
169-the carrier’s enrollees under the carrier’s health benefit plan. 15
211+ 4. contact information for the health care facility; and 9
170212
171- (ii) “Provider panel” does not include an arrangement in which any 16
172-provider may participate solely by contracting with the carrier to provide health care 17
173-services at a discounted fee–for–service rate. 18
213+ (iii) a statement that advises enrollees and prospective enrollees to 10
214+contact a provider or a health care facility before seeking treatment or services, to confirm 11
215+the provider’s or health care facility’s participation in the carrier’s network AND THE 12
216+ENROLLEE’S HEALTH BENEFIT PLA N. 13
174217
175- (n) (1) A carrier shall make the carrier’s [network] PROVIDER directory 19
176-available to prospective enrollees on the Internet and, on request of a prospective enrollee, 20
177-in printed form. 21
218+ (p) (1) A carrier shall notify each enrollee at the time of initial enrollment and 14
219+renewal about how to access or obtain the information required under subsection (n) of this 15
220+section. 16
178221
179- (2) The carrier’s [network] PROVIDER directory on the Internet shall be 22
180-available: 23
222+ (2) (i) 1. Information provided in printed form under subsection (n) 17
223+of this section shall be accurate on the date of publication. 18
181224
182- (i) through a clear link or tab; and 24
225+ 2. A carrier shall update the information provided in printed 19
226+form at least once a year. 20
183227
184- (ii) in a searchable format. 25
228+ (ii) 1. Information provided on the Internet under subsection (n) 21
229+of this section shall be accurate on the date of initial posting and any update. 22
185230
186- (3) The [network] PROVIDER directory shall include: 26
231+ 2. In addition to the requirement to update its provider 23
232+information under subsection (t)(1) of this section, a carrier shall update the information 24
233+provided on the Internet at least once every 15 days. 25
187234
188- (i) for each provider on the carrier’s provider panel: 27
235+ (3) A carrier shall: 26
189236
190- 1. the name of the provider; 28
237+ (i) 1. periodically review at least a reasonable sample size of its 27
238+[network] PROVIDER directory for accuracy; and 28
191239
192- 2. the specialty areas of the provider; 29
240+ 2. retain documentation of the review and make the review 29
241+available to the Commissioner on request; or 30
242+ 6 HOUSE BILL 1292
193243
194- 3. whether the provider currently is accepting new patients; 30 HOUSE BILL 1292 5
244+
245+ (ii) contact providers listed in the carrier’s [network] PROVIDER 1
246+directory who have not submitted a claim in the last 6 months to determine if the providers 2
247+intend to remain in the carrier’s provider network. 3
248+
249+ (4) A carrier shall demonstrate the accuracy of the information provided 4
250+under paragraph (3) of this subsection on request of the Commissioner. 5
251+
252+ (5) A CARRIER SHALL INCLUD E IN A PROVIDER DIRE CTORY THAT IS 6
253+IN PRINTED FORM A ST ATEMENT NOTIFYING A READER THAT : 7
254+
255+ (I) THE INFORMATION CONT AINED IN THE PROVIDE R 8
256+DIRECTORY IS ACCURAT E AS OF THE DATE OF PUBLICATION; AND 9
257+
258+ (II) TO OBTAIN THE MOST C URRENT INFORMATION , THE 10
259+INDIVIDUAL SHOULD CO NSULT THE PROVIDER D IRECTORY ON THE INTERNET OR 11
260+CONTACT THE CARRIER DIRECTLY. 12
261+
262+ [(5)] (6) Before imposing a penalty against a carrier for inaccurate 13
263+network directory information, the Commissioner shall take into account, in addition to 14
264+any other factors required by law, whether: 15
265+
266+ (i) the carrier afforded a provider or other person identified in § 16
267+15–112.3(c) of this subtitle an opportunity to review and update the provider’s network 17
268+directory information: 18
269+
270+ 1. through the multi–carrier common online provider 19
271+directory information system designated under § 15–112.3 of this subtitle; or 20
272+
273+ 2. directly with the carrier; 21
274+
275+ (ii) the carrier can demonstrate the efforts made, in writing, 22
276+electronically, or by telephone, to obtain updated network directory information from a 23
277+provider or other person identified in § 15–112.3(c) of this subtitle; 24
278+
279+ (iii) the carrier has contacted a provider listed in the carrier’s 25
280+network directory who has not submitted a claim in the last 6 months to determine if the 26
281+provider intends to remain on the carrier’s provider panel; 27
282+
283+ (iv) the carrier includes in its network directory the last date that a 28
284+provider updated the provider’s information; 29
285+
286+ (v) the carrier has implemented any other process or procedure to: 30
287+
288+ 1. encourage providers to update their network directory 31
289+information; or 32
290+ HOUSE BILL 1292 7
291+
292+
293+ 2. increase the accuracy of its network directory; and 1
294+
295+ (vi) a provider or other person identified in § 15–112.3(c) of this 2
296+subtitle has not updated the provider’s network directory information, despite 3
297+opportunities to do so. 4
298+
299+ (t) (1) (I) A SUBJECT TO SUBPARAGRAPH (II) OF THIS PARAGRAPH , A 5
300+carrier shall update the information that must be made available on the Internet under 6
301+subsection (n) of this section within [15] 2 working days after receipt of electronic 7
302+notification or notification by first–class mail tracking method from the participating 8
303+provider of a change in the applicable information. 9
304+
305+ (II) A DENTAL CARRIER SHALL UPDATE THE INFORMATI ON 10
306+REQUIRED BY THIS SUB SECTION WITHIN 15 WORKING DAYS AFTER R ECEIPT OF THE 11
307+NOTIFICATION DESCRIB ED IN SUBPARAG RAPH (I) OF THIS PARAGRAPH . 12
308+
309+ (2) Notification is presumed to have been received by a carrier: 13
310+
311+ (i) 3 working days after the date the participating provider placed 14
312+the notification in the U.S. mail, if the participating provider maintains the stamped 15
313+certificate of mailing for the notice; or 16
314+
315+ (ii) on the date recorded by the courier, if the notification was 17
316+delivered by courier. 18
317+
318+ (3) AT LEAST ONCE EVERY 90 DAYS, EACH CARRIER SHALL V ERIFY 19
319+AND, AS NECESSARY , UPDATE THE INFORMATI ON INCLUDED IN THE CARRIER’S 20
320+PROVIDER DIRECTORY . 21
321+
322+15–112.3. 22
323+
324+ (a) (1) In this section the following words have the meanings indicated. 23
325+
326+ (3) “Multi–carrier common online provider directory information system” 24
327+means the system designated by the Commissioner for use by providers to provide and 25
328+update their [network] PROVIDER directory information with carriers. 26
329+
330+ (c) A carrier shall accept new and updated [network] PROVIDER directory 27
331+information for a provider submitted: 28
332+
333+ (1) (i) through the multi–carrier common online provider directory 29
334+information system; or 30
335+
336+ (ii) directly to the carrier; and 31
337+
338+ (2) from: 32 8 HOUSE BILL 1292
195339
196340
197341
198- 4. for each office of the provider where the provider 1
199-participates on the provider panel: 2
342+ (i) the provider; 1
200343
201- A. its location, including its address; and 3
344+ (ii) a hospital or academic medical center that: 2
202345
203- B. contact information for the provider; 4
346+ 1. is a participating provider on the carrier’s provider panel; 3
347+and 4
204348
205- 5. the gender of the provider, if the provider notifies the 5
206-carrier or the multi–carrier common online provider directory information system 6
207-designated under § 15–112.3 of this subtitle of the information; and 7
349+ 2. acts as a credentialing intermediary for the carrier for 5
350+providers that: 6
208351
209- 6. any languages spoken by the provider other than English, 8
210-if the provider notifies the carrier or the multi–carrier common online provider directory 9
211-information system designated under § 15–112.3 of this subtitle of the information; 10
352+ A. participate on the carrier’s provider panel; and 7
212353
213- (ii) for each health care facility in the carrier’s network: 11
354+ B. have privileges at the hospital or academic medical center; 8
355+or 9
214356
215- 1. the health care facility’s name; 12
357+ (iii) any other person that performs credentialing functions on behalf 10
358+of a provider. 11
216359
217- 2. the health care facility’s address; 13
360+15–830. 12
218361
219- 3. the types of services provided by the health care facility; 14
220-and 15
362+ (g) (2) Each carrier shall make a copy of each of the procedures filed under 13
363+paragraph (1) of this subsection available to its members: 14
221364
222- 4. contact information for the health care facility; and 16
365+ (i) in the carrier’s online [network] PROVIDER directory required 15
366+under § 15–112(n)(1) of this title; and 16
223367
224- (iii) a statement that advises enrollees and prospective enrollees to 17
225-contact a provider or a health care facility before seeking treatment or services, to confirm 18
226-the provider’s or health care facility’s participation in the carrier’s network AND THE 19
227-ENROLLEE’S HEALTH BENEFIT PLAN . 20
368+ SECTION 2. AND BE IT FURTHER ENACTED, That, on or before January 1, 2026, 17
369+the Commission shall report to the General Assembly, in accordance with § 2–1257 of the 18
370+State Government Article, on any changes to regulations related to the accuracy of provider 19
371+directories. 20
228372
229- (p) (1) A carrier shall notify each enrollee at the time of initial enrollment and 21
230-renewal about how to access or obtain the information required under subsection (n) of this 22
231-section. 23
232-
233- (2) (i) 1. Information provided in printed form under subsection (n) 24
234-of this section shall be accurate on the date of publication. 25
235-
236- 2. A carrier shall update the information provided in printed 26
237-form at least once a year. 27
238-
239- (ii) 1. Information provided on the Internet under subsection (n) 28
240-of this section shall be accurate on the date of initial posting and any update. 29
241- 6 HOUSE BILL 1292
242-
243-
244- 2. In addition to the requirement to update its provider 1
245-information under subsection (t)(1) of this section, a carrier shall update the information 2
246-provided on the Internet at least once every 15 days. 3
247-
248- (3) A carrier shall: 4
249-
250- (i) 1. periodically review at least a reasonable sample size of its 5
251-[network] PROVIDER directory for accuracy; and 6
252-
253- 2. retain documentation of the review and make the review 7
254-available to the Commissioner on request; or 8
255-
256- (ii) contact providers listed in the carrier’s [network] PROVIDER 9
257-directory who have not submitted a claim in the last 6 months to determine if the providers 10
258-intend to remain in the carrier’s provider network. 11
259-
260- (4) A carrier shall demonstrate the accuracy of the information provided 12
261-under paragraph (3) of this subsection on request of the Commissioner. 13
262-
263- (5) A CARRIER SHALL INCLUD E IN A PROVIDER DIRE CTORY THAT IS 14
264-IN PRINTED FORM A ST ATEMENT NOTIFYING A READER THAT : 15
265-
266- (I) THE INFORMATION CONT AINED IN THE PROVIDE R 16
267-DIRECTORY IS ACCURAT E AS OF THE DATE OF PUBLICATION; AND 17
268-
269- (II) TO OBTAIN THE MOST C URRENT INFORMATION , THE 18
270-INDIVIDUAL SHOULD CO NSULT THE PROVIDER D IRECTORY ON THE INTERNET OR 19
271-CONTACT THE CARRIER DIRECTLY. 20
272-
273- [(5)] (6) Before imposing a penalty against a carrier for inaccurate 21
274-network directory information, the Commissioner shall take into account, in addition to 22
275-any other factors required by law, whether: 23
276-
277- (i) the carrier afforded a provider or other person identified in § 24
278-15–112.3(c) of this subtitle an opportunity to review and update the provider’s network 25
279-directory information: 26
280-
281- 1. through the multi–carrier common online provider 27
282-directory information system designated under § 15–112.3 of this subtitle; or 28
283-
284- 2. directly with the carrier; 29
285-
286- (ii) the carrier can demonstrate the efforts made, in writing, 30
287-electronically, or by telephone, to obtain updated network directory information from a 31
288-provider or other person identified in § 15–112.3(c) of this subtitle; 32
289- HOUSE BILL 1292 7
290-
291-
292- (iii) the carrier has contacted a provider listed in the carrier’s 1
293-network directory who has not submitted a claim in the last 6 months to determine if the 2
294-provider intends to remain on the carrier’s provider panel; 3
295-
296- (iv) the carrier includes in its network directory the last date that a 4
297-provider updated the provider’s information; 5
298-
299- (v) the carrier has implemented any other process or procedure to: 6
300-
301- 1. encourage providers to update their network directory 7
302-information; or 8
303-
304- 2. increase the accuracy of its network directory; and 9
305-
306- (vi) a provider or other person identified in § 15–112.3(c) of this 10
307-subtitle has not updated the provider’s network directory information, despite 11
308-opportunities to do so. 12
309-
310- (t) (1) (I) A SUBJECT TO SUBPARAGRAPH (II) OF THIS PARAGRAPH , A 13
311-carrier shall update the information that must be made available on the Internet under 14
312-subsection (n) of this section within [15] 2 working days after receipt of electronic 15
313-notification or notification by first–class mail tracking method from the participating 16
314-provider of a change in the applicable information. 17
315-
316- (II) A DENTAL CARRIER SHALL UPDATE THE INFORMATI ON 18
317-REQUIRED BY THIS SU BSECTION WITHIN 15 WORKING DAYS AFTER R ECEIPT OF THE 19
318-NOTIFICATION DESCRIB ED IN SUBPARAGRAPH (I) OF THIS PARAGRAPH . 20
319-
320- (2) Notification is presumed to have been received by a carrier: 21
321-
322- (i) 3 working days after the date the participating provider placed 22
323-the notification in the U.S. mail, if the participating provider maintains the stamped 23
324-certificate of mailing for the notice; or 24
325-
326- (ii) on the date recorded by the courier, if the notification was 25
327-delivered by courier. 26
328-
329- (3) AT LEAST ONCE EVERY 90 DAYS, EACH CARRIER SHALL V ERIFY 27
330-AND, AS NECESSARY , UPDATE THE INFORMATI ON INCLUDED IN THE C ARRIER’S 28
331-PROVIDER DIRECTORY . 29
332-
333-15–112.3. 30
334-
335- (a) (1) In this section the following words have the meanings indicated. 31
336- 8 HOUSE BILL 1292
337-
338-
339- (3) “Multi–carrier common online provider directory information system” 1
340-means the system designated by the Commissioner for use by providers to provide and 2
341-update their [network] PROVIDER directory information with carriers. 3
342-
343- (c) A carrier shall accept new and updated [network] PROVIDER directory 4
344-information for a provider submitted: 5
345-
346- (1) (i) through the multi–carrier common online provider directory 6
347-information system; or 7
348-
349- (ii) directly to the carrier; and 8
350-
351- (2) from: 9
352-
353- (i) the provider; 10
354-
355- (ii) a hospital or academic medical center that: 11
356-
357- 1. is a participating provider on the carrier’s provider panel; 12
358-and 13
359-
360- 2. acts as a credentialing intermediary for the carrier for 14
361-providers that: 15
362-
363- A. participate on the carrier’s provider panel; and 16
364-
365- B. have privileges at the hospital or academic medical center; 17
366-or 18
367-
368- (iii) any other person that performs credentialing functions on behalf 19
369-of a provider. 20
370-
371-15–830. 21
372-
373- (g) (2) Each carrier shall make a copy of each of the procedures filed under 22
374-paragraph (1) of this subsection available to its members: 23
375-
376- (i) in the carrier’s online [network] PROVIDER directory required 24
377-under § 15–112(n)(1) of this title; and 25
378-
379- SECTION 2. AND BE IT FURTHER ENACTED, That, on or before January 1, 2026, 26
380-the Commission Insurance Commissioner shall report to the General Assembly, in 27
381-accordance with § 2–1257 of the State Government Article, on any changes to regulations 28
382-related to the accuracy of provider directories. 29
383- HOUSE BILL 1292 9
384-
385-
386- SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 1
387-October 1, 2025. 2
373+ SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 21
374+October 1, 2025. 22
388375
389376
390377
391378
392379 Approved:
393380 ________________________________________________________________________________
394381 Governor.
395382 ________________________________________________________________________________
396383 Speaker of the House of Delegates.
397384 ________________________________________________________________________________
398385 President of the Senate.