Maryland Medical Assistance Program and Health Insurance - Claims for Reimbursement - Downcoding
Hearing (House)
Summary
The bill bars insurers, nonprofit health service plans, HMOs and managed‑care organizations from lowering the service code on a provider’s claim to reduce payment, except after a defined clinical review. It requires written notice to providers, a physician‑led determination, an appeal right, quarterly reporting, and fines up to $10,000 per violation. The goal is to protect providers and patients from improper payment reductions.
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3 free questions a day, no accountHearings
- Health — Bill HearingHealth · Mar 5, 2026
History
- Hearing 3/05 at 1:00 p.m.
- First Reading Health
Sponsors
- Guzzone · sponsor
- D. Jones
- Hill
- Kaiser
- Lehman
- Moreno
- Pruski
- Qi
- Taveras
- Watson
- Woods
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