nsurance Anti-Fraud Plan Required - HB142

BULLETIN 09-24 Date: August 31, 2009 To: All Third Party Administrators Re: Insurance Anti-Fraud Plans Required (HB 142) Effective October 1, 2009, all Third Party Administrators (see Insurance Art., §8-301) acting in the State of Maryland are required to institute and file with the Commissioner an antifraud plan, as detailed in §27-803 and COMAR 31.04.15. HB 142, enacted by the 2009 General Assembly and signed into law by Governor O’Malley, added TPA’s to the list of entities already required to institute and file such plans (“authorized insurers” and HMO’s). Said plans must detail specific procedures to prevent insurance fraud (including internal fraud, application fraud and claims fraud), to report insurance fraud to appropriate authorities (§27-802 of the Insurance Art.), to cooperate in the investigation and prosecution of insurance fraud, and to report fraud-related data to the Commissioner and the Fraud Division of the Maryland Insurance Administration. This requirement applies regardless of whether a TPA’s insurer has filed a plan. An informational packet prepared by MIA’s Fraud Division is available online on the MIA’s Fraud Division website, by calling Diane Blank, at 410-468-3968, or by emailing her at dblank@mdinsurance.state.md.us. Signature on file with original ______________________________ Carolyn H. Henneman Associate Commissioner Insurance Fraud Division Maryland Insurance Adminstration RALPH S. TYLER Commissioner BETH SAMMIS KAREN STAKEM HORNIG Deputy Commissioners MARTIN O’MALLEY Governor ANTHONY G. BROWN Lt. Governor 200 St. Paul Place, Suite 2700, Baltimore, Maryland 21202 1-800-492-6116 TTY: 1-800-735-2258 www.mdinsurance.state.md.us