<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 31.10.41.05" title_num="31" subtitle_num="10" chapter_num="41" heading="Assignment of Benefits — Nonpreferred Providers.">
  <paragraph num="A.">
    <text>This regulation applies to carriers who receive claims for services provided by physicians who are nonpreferred providers but are not on-call physicians or hospital-based physicians.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A carrier shall permit a nonpreferred provider described in §A of this regulation to accept an assignment of benefits under a preferred provider insurance policy offered by the carrier.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Except as provided in Insurance Article, §14-205.3(g), Annotated Code of Maryland, a carrier that receives a claim for services provided by a nonpreferred provider described in §A of this regulation who accepts an assignment of benefits under a preferred provider insurance policy shall pay the nonpreferred provider directly if the nonpreferred provider:</text>
    <paragraph num="(1)">
      <text>Provides a copy of the disclosure set forth in Regulation .06 of this chapter to an insured before performing a health care service for the insured; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Submits a copy of the signed disclosure set forth in Regulation .06 of this chapter to the carrier.</text>
    </paragraph>
  </paragraph>
</regulation>