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Statutes Text

Article - Insurance


    (a)    (1)    In this section the following words have the meanings indicated.

        (2)    “Carrier” means:

            (i)    an insurer;

            (ii)    a nonprofit health service plan;

            (iii)    a health maintenance organization; or

            (iv)    any other person that provides health benefit plans subject to regulation by the State.

        (3)    “Group model health maintenance organization” has the meaning stated in § 19–713.6(a) of the Health – General Article.

    (b)    This section applies only to contracts or policies that:

        (1)    are issued or delivered by a carrier; and

        (2)    provide hospital, medical, or surgical benefits to individuals or groups on an expense–incurred basis.

    (c)    (1)    Except as provided in subsection (d) of this section, each carrier shall pay a bonus to primary care providers for services provided in the office:

            (i)    after 6 p.m. and before 8 a.m.; or

            (ii)    on weekends and national holidays.

        (2)    A carrier shall provide for and describe the terms of the bonus payment required in paragraph (1) of this subsection in a separate clause in the carrier’s contract with the primary care provider.

    (d)    A group model health maintenance organization is not required to make any bonus payments described in subsection (c) of this section to physicians that are employed by the physician group under contract with the group model health maintenance organization.

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