Coverage for outpatient services and second opinions

Checkout our iOS App for a better way to browser and research.

    (a)    This section applies to:

        (1)    each individual, group, or blanket health insurance policy that is issued or delivered in the State by an insurer; and

        (2)    each contract or certificate that is issued or delivered in the State by a nonprofit health service plan.

    (b)    A policy, contract, or certificate subject to this section that provides coverage for an inpatient service in an acute general hospital shall provide coverage for:

        (1)    a corresponding outpatient service that is provided to the insured instead of the inpatient service because of the denial, after review under a utilization review program, of a request by the attending physician for an inpatient admission; and

        (2)    an objective second opinion given to the insured when required by a utilization review program under § 19-319 of the Health - General Article.


Download our app to see the most-to-date content.