31.01.02.06 - Life and Health
31.01.02.06. Life and Health
A. The bulletin issued by the Commissioner under Regulation .05 of this chapter may require health carriers to:
(1) Suspend health benefit cancellations and nonrenewals;
(2) Allow a provider in the geographic area to which the regulation applies to submit a claim for service provided 30 calendar days prior to the effective date of the regulation, up to 240 calendar days after the date the service was rendered;
(3) Waive any time restrictions on prescription medication refills and authorize payment to pharmacies for at least a 30-day supply of any prescription medication, regardless of the date upon which the prescription medication had most recently been filled by a pharmacist; and
(4) Waive any restrictions on the time frame for the replacement of durable medical equipment or supplies, eyeglasses, and dentures.
B. A health carrier may cancel or refuse to renew any health benefits if all premiums due are not paid within 60 calendar days following the date the bulletin issued pursuant to Regulation .05D of this chapter expires.
C. The effective date of cancellation or refusal to renew pursuant to § B of this regulation is the date the health carrier was originally permitted to take such action after the expiration of any applicable grace period.
D. The Commissioner may extend any time frames required for processing claims for a health carrier if the health carrier requests an extension in writing and demonstrates the legitimate reason for the business disruption to the Commissioner.
E. The Commissioner may suspend the requirement to pay interest on claims as required by Insurance Article, § 15-1005, Annotated Code of Maryland, if the health carrier requests such suspension in writing and demonstrates to the Commissioner a legitimate reason for the suspension of the requirement to pay interest.(Regulation .06 amended effective 47:26 Md. R. 1108, eff. 12/28/2020)
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