# COMAR Title 31 — Maryland Insurance Administration

## Subtitle 12 — Health Maintenance Organizations; Entities That Act as Health Insurers

### Chapter 08 — Payments to Nonparticipating Providers

#### Regulation .06 Other Covered Services.

*COMAR 31.12.08.06*

If a nonparticipating provider submits a claim to a health maintenance organization for a covered service other than a covered evaluation and management service, the health maintenance organization shall pay the nonparticipating provider, less any applicable copayment, coinsurance or deductible amount, an amount not less than 125 percent of the rate for the covered service in the annual rate schedule applicable to similarly licensed providers in the same geographic area.