Maryland Code § CL-13-4A-02

Section CL-13-4A-02
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(a) The Unit may implement an educational and advocacy program
designed to:
(1) Enable health care consumers to make more informed choices in
the health marketplace, and to be able to participate in decisions concerning their
health care; and
(2) Otherwise promote the interest of health consumers in the health
marketplace.

(b) (1) (i) The Unit may assist health care consumers in
understanding their health care bills and third party coverage, in identifying
improper billing or coverage determinations, and in reporting any billing or coverage
problems to appropriate entities, including the Division, the Attorney General or
other governmental agencies, insurers, or providers.
(ii) Whenever the Unit requests information from an insurer,
nonprofit health service plan, or health maintenance organization in order to assist
a health care consumer for the purposes provided in this paragraph, the insurer,
nonprofit health service plan, or health maintenance organization shall provide the
information to the Unit no later than 7 working days from the date the insurer,
nonprofit health service plan, or health maintenance organization received the
request.
(2) Whenever any billing or coverage question concerns the adequacy
or propriety of any services or treatment, the Unit shall refer the matter to an
appropriate professional, licensing, or disciplinary body, as applicable. The Unit may
monitor the progress of the concerns raised by health consumers through such
referrals.
(3) Whenever any billing or coverage question concerns a matter
within the jurisdiction of the Insurance Commissioner, the Unit shall refer the matter
to the Commissioner. The Unit may monitor the progress of the concerns raised by
health consumers through such referrals.
(4) The Unit shall work with the Maryland Department of Health to
assist with resolving any billing or coverage questions as necessary.
(c) The Unit may:
(1) Recommend to the Attorney General, the Governor, the General
Assembly, or other appropriate governmental agencies any measures that will
promote the interests of health consumers in the health marketplace; and
(2) Present for consideration relevant information on the effects on
health care consumers generally in any agency proceeding which is otherwise open
to the public.
(d) Nothing in this section shall mean that the Unit may have authority to
bring any civil action seeking review of a State agency determination.

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