Contract Filings for HMOs Participating in the Small Group Market

STATE OF MARYLAND MARYLAND INSURANCE ADMINISTRATION 525 ST. PAUL PLACE, BALTIMORE, MARYLAND 21202-2272 WRITER’S DIRECT DIAL: 410-468-2201 Facsimile Number: 410-468-2204 e-mail : wtaparanskas@mdinsurance.state.md.us Bulletin DATE: March 28, 2002 TO: Health Maintenance Organizations Participating in the Small Group Market RE: Contract Filings BULLETIN NO.: Life and Health 02-4 We would like to bring to your attention revisions that will be required of the small group contracts issued or renewed on or after July 1, 2002. These revisions were published in the Maryland Register on December 28, 2001. Notice of Final Action was published in the Maryland Register on March 8, 2002. We recommend that these changes be made through an amendment rider which will be attached to the group policy and certificate. Please specify the form number and date of approval of the policy to which the amendment rider will be attached. To ensure approval by July 1, 2002, the filings must be received by this Administration by May 1, 2002. Revisions Required By COMAR 31.11.06
Experimental Services definition  Modified this definition to refer to the edition of the Institute of Medicine Report on Assessing Medical Technologies that is current when the care is rendered. See COMAR 31.11.06.02B(16).
New benefit for hearing aids for minor children ages 0 to 18. See COMAR 31.11.06.03A(34).
Hearing Aid Exclusion  Modified Exclusion #24 to add an exception for covered hearing aids for minor children. See COMAR 31.11.06.06B(24). PARRIS N. GLENDENING GOVERNOR KATHLEEN KENNEDY TOWNSEND LIEUTENANT GOVERNOR STEVEN B. LARSEN COMMISSIONER DONNA B. IMHOFF DEPUTY COMMISSIONER WENDY TAPARANSKAS ASSOCIATE COMMISSIONER LIFE & HEALTH Page 2 In addition, we would like to bring to your attention a change in one of the laws referenced in COMAR 31.11.06.09. Section 19-710.1(b)(1)(ii) of the Health-General Article, which applies to the Comprehensive Standard Health Benefit Plan, was modified to address reimbursement to noncontracting providers for services rendered to trauma patients at designated trauma centers. Any revisions necessary to comply with the requirements of §19-710.1(b)(1)(ii) of the Health-General Article, as revised, should be included in the rider or amendment with the other changes. We are enclosing copies of the changes to the small group regulations published on December 28, 2001 and March 8, 2002. Please contact Ellen Woodall, Supervisor, Managed Care Unit at (410) 468-2226 if you have any questions regarding these filings. ______________________________ Wendy Taparanskas, Ph.D. Associate Commissioner Life and Health Enclosure