<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".21" citation="COMAR 10.14.02.21" title_num="10" subtitle_num="14" chapter_num="02" heading="Billing and Reimbursement Time Limitations.">
  <paragraph num="A.">
    <text>The Program may not reimburse claims received for payment more than 12 months after the date of service except as specified in §§B—D of this regulation.</text>
  </paragraph>
  <paragraph num="B.">
    <text>To obtain reimbursement from the Program, a health care provider that originally submits a claim to Medicare or another health insurer shall also submit the claim to the Program within a period whereby the Program receives the claim within the latter of:</text>
    <paragraph num="(1)">
      <text>12 months after the date of service; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>6 months from the Medicare or other health insurer remittance date as shown on the explanation of benefits.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The Program shall pay a claim that is originally rejected for payment due to improper completion or incomplete information only if:</text>
    <paragraph num="(1)">
      <text>The health care provider properly completes and resubmits the claim to the Program; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The Program receives the resubmitted claim within the latter of:</text>
      <paragraph num="(a)">
        <text>The original 12 month period from the date of service; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>6 months after claim rejection.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>When the Program initially rejects a claim for payment in error, the Program shall pay the claim if the participating health care provider resubmits the claim and the resubmitted claim is received by the Program within the same period specified in §C of this regulation.</text>
  </paragraph>
</regulation>