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WES MOORE, Governor Ch. 706
Chapter 706
(Senate Bill 808)
AN ACT concerning
Health Insurance – Provider Panels – Requirements
FOR the purpose of altering the process though through which health care providers apply
to participate on a carrier’s provider panel, including for certain notice requirements;
establishing certain civil penalties for carriers that fail to provide certain notices in
a certain manner and certain time frame; repealing the authorization for a carrier
to charge a certain application fee; requiring carriers to use certain information to
update the carrier’s provider directory at a certain frequency; altering a requirement
for certain carriers to update certain information on a provider directory within a
certain period of time after receipt of certain notices; altering a requirement for
carriers to reimburse for certain covered services provided by a nonparticipating
provider; expanding the types of providers a carrier is prohibited from limiting on a
provider panel; altering the credentialing applications that the Maryland Insurance
Commissioner may designate for a certain credentialing system and the
circumstances under which the designation may be made; altering certain
requirements for a multi–carrier common online provider directory information
system; and generally relating to health insurance provider panels.
BY repealing and reenacting, with amendments,
Article – Insurance
Section 15–112(a), (g), (p), (t), and (w), and (x) 15–112.1, and 15–112.3
Annotated Code of Maryland
(2017 Replacement Volume and 2025 Supplement)
BY repealing and reenacting, without amendments,
Article – Insurance
Section 15–112(n), (o), and (u) and 15–112.1
Annotated Code of Maryland
(2017 Replacement Volume and 2025 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Insurance
15–112.
(a) (1) In this section the following words have the meanings indicated.
(2) “Accredited hospital” has the meaning stated in § 19–301 of the
Health – General Article.
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Ch. 706 2026 LAWS OF MARYLAND
(3) “Ambulatory surgical facility” has the meaning stated in § 19–3B–01 of
the Health – General Article.
(4) “Behavioral health care services” has the meaning stated in § 15–127
of this subtitle.
(5) (i) “Carrier” means:
1. an insurer;
2. a nonprofit health service plan;
3. a health maintenance organization;
4. a dental plan organization; or
5. any other person that provides health benefit plans
subject to regulation by the State.
(ii) “Carrier” includes an entity that arranges a provider panel for a
carrier.
(6) “Credentialing intermediary” means a person to whom a carrier has
delegated credentialing or recredentialing authority and responsibility.
(7) “Enrollee” means a person entitled to health care benefits from a
carrier.
(8) “Group model health maintenance organization” has the meaning
stated in § 19–713.6(a) of the Health – General Article.
(9) “Health benefit plan”:
(i) for a group or blanket plan in the large group market, has the
meaning stated in § 15–1401 of this title;
(ii) for a group in the small group market, has the meaning stated in
§ 31–101 of this article; and
(iii) for an individual plan, has the meaning stated in § 15–1301 of
this title.
(10) (i) “Health care facility” means a health care setting or institution
providing physical, mental, or substance use disorder health care services.
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WES MOORE, Governor Ch. 706
(ii) “Health care facility” includes:
1. a hospital;
2. an ambulatory surgical or treatment center;
3. a skilled nursing facility;
4. a residential treatment center;
5. an urgent care center;
6. a diagnostic, laboratory, or imaging center;
7. a rehabilitation facility; and
8. any other therapeutic health care setting.
(11) “Hospital” has the meaning stated in § 19–301 of the Health – General
Article.
(12) “Network” means a carrier’s participating providers and the health care
facilities with which a carrier contracts to provide health care services to the carrier’s
enrollees under the carrier’s health benefit plan.
(13) “Online credentialing system” means the system through which a
provider may access AND SUBMIT an online provider credentialing application that the
Commissioner has designated as the uniform credentialing form under § 15–112.1(e) of this
subtitle.
(14) “Participating provider” means a provider on a carrier’s provider panel.
(15) “Provider” means a health care practitioner or group of health care
practitioners licensed, certified, or otherwise authorized by law to provide health care
services.
(16) “Provider directory” means a list of a carrier’s participating providers
and participating health care facilities.
(17) (i) “Provider panel” means the providers that contract either
directly or through a subcontracting entity with a carrier to provide health care services to
the carrier’s enrollees under the carrier’s health benefit plan.
(ii) “Provider panel” does not include an arrangement in which any
provider may participate solely by contracting with the carrier to provide health care
services at a discounted fee–for–service rate.
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Ch. 706 2026 LAWS OF MARYLAND
(g) (1) A provider that seeks to participate on a provider panel of a carrier shall
submit an application to the carrier.
(2) (i) Subject to subparagraph (ii) of this paragraph and paragraph (3)
of this subsection, the carrier, after reviewing the application, shall accept or reject the
provider for participation on the carrier’s provider panel.
(ii) A carrier may not reject a provider who provides
community–based health services for a program accredited under COMAR 10.63.02 for
participation on the carrier’s provider panel because the provider practices within the scope
of the provider’s license and is:
1. a licensed master social worker, as defined in § 19–101 of
the Health Occupations Article;
2. a licensed graduate alcohol and drug counselor, a licensed
graduate marriage and family therapist, a licensed graduate professional art therapist, or
a licensed graduate professional counselor, as those terms are defined in § 17–101 of the
Health Occupations Article; or
3. a registered psychology associate, as defined in § 18–101
of the Health Occupations Article.
(iii) [If] IN ACCORDANCE WITH PARAGRAPH (3) OF THIS
SUBSECTION, IF the carrier rejects the provider for participation on the carrier’s provider
panel, the carrier shall send to the provider [at the address listed in the application] written
notice of the rejection.
(3) (i) Subject to paragraph (4) of this subsection, within [30] 5 15 days
after the date a carrier receives a completed application, the carrier shall send to the
provider at the E–MAIL address listed in the application OR, IF AN E–MAIL ADDRESS IS
NOT LISTED IN THE APPLICATION, THE MAILING ADDRESS LISTED IN THE
APPLICATION written notice of:
1. the carrier’s intent to continue to process the provider’s
application to obtain necessary credentialing information; or
2. the carrier’s rejection of the provider for participation on
the carrier’s provider panel.
(ii) The failure of a carrier to provide the notice required under
subparagraph (i) of this paragraph is a violation of this article and the carrier is subject to:
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WES MOORE, Governor Ch. 706
1. A CIVIL PENALTY OF $500 PER DAY FOR EACH DAY
THE NOTICE WAS NOT SENT, TO BE COLLECTED BY THE COMMISSIONER AND PAID
TO THE PROVIDER; AND
2. the penalties provided by § 4–113(d) of this article.
(iii) Except as provided in subsection (v) of this section and
subparagraph (iv) of this paragraph, if, under subparagraph (i)1 of this paragraph, a carrier
provides notice to the provider of its intent to continue to process the provider’s application
to obtain necessary credentialing information, the carrier, within [120] 30 60 days after
the date the notice is provided, shall:
1. accept or reject the provider for participation on the
carrier’s provider panel; and
2. send written notice of the acceptance or rejection to the
provider at the E–MAIL address listed in the application OR, IF AN E–MAIL ADDRESS IS
NOT LISTED IN THE APPLICATION, THE MAILING ADDRESS LISTED IN THE
APPLICATION.
(iv) For a provider described in paragraph (2)(ii) of this subsection,
if, under subparagraph (i)1 of this paragraph, a carrier provides notice to the provider of
its intent to continue to process the provider’s application to obtain necessary credentialing
information, within [60] 15 30 days after the date a carrier receives a completed
application, the carrier shall:
1. accept or reject the provider for participation on the
carrier’s provider panel; and
2. send written notice of the acceptance or rejection to the
provider at the E–MAIL address listed in the application OR, IF AN E–MAIL ADDRESS IS
NOT LISTED IN THE APPLICATION, THE MAILING ADDRESS LISTED IN THE
APPLICATION.
(v) The failure of a carrier to provide the notice required under
subparagraph (iii)2 or (iv) of this paragraph is a violation of this article and the carrier is
subject to:
1. A CIVIL PENALTY OF $500 PER DAY FOR EACH DAY
THE NOTICE WAS NOT SENT, TO BE COLLECTED BY THE COMMISSIONER AND PAID
TO THE PROVIDER; AND
2. the provisions of and penalties provided by §§ 4–113 and
4–114 of this article.
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Ch. 706 2026 LAWS OF MARYLAND
(4) (i) [1. Except as provided in subsubparagraph 4 of this
subparagraph, a] A carrier that receives a complete application shall [notify] SEND
WRITTEN NOTICE TO the provider that the application is complete[.
2. If a carrier does not accept applications through the online
credentialing system, notice shall be given to the provider] at the E–MAIL address listed in
the application OR, IF AN E–MAIL ADDRESS IS NOT LISTED IN THE APPLICATION, THE
MAILING ADDRESS LISTED IN THE APPLICATION within 10 days after the date the
application is received.
[3. If a carrier accepts applications through the online
credentialing system, the notice from the online credentialing system to the provider that
the carrier has received the provider’s application shall be considered notice that the
application is complete.
4. This subparagraph does not apply to a carrier that
arranges a dental provider panel until the Commissioner certifies that the online
credentialing system is capable of accepting the uniform credentialing form designated by
the Commissioner for dental provider panels.]
(ii) 1. (I) A carrier that receives an incomplete application shall
return the application to the provider at the E–MAIL address listed in the application OR,
IF AN E–MAIL ADDRESS IS NOT LISTED IN THE APPLICATION, THE MAILING ADDRESS
LISTED IN THE APPLICATION within 10 days after the date the application is received.
2. (II) The carrier shall indicate to the provider what information
is needed to make the application complete.
3. (III) The provider may return the completed application
to the carrier.
4. (IV) After the carrier receives the completed application,
the carrier is subject to the time periods established in paragraph (3) of this subsection.
(5) (I) IN THIS PARAGRAPH, “UNIFORM CREDENTIALING FORM”
MEANS THE FORM DESIGNATED BY THE COMMISSIONER UNDER § 15–112.1(E) OF
THIS SUBTITLE.
(II) A carrier [may charge a reasonable fee for an application
submitted to the carrier under this section] SHALL:
1. ALLOW A PROVIDER TO SUBMIT THE UNIFORM
CREDENTIALING FORM USING THE ONLINE CREDENTIALING SYSTEM;
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WES MOORE, Governor Ch. 706
2. ESTABLISH A DIRECT TELEPHONE NUMBER FOR
INQUIRIES ON THE UNIFORM CREDENTIALING FORM THAT IS MONITORED BY THE
CARRIER AND IS NOT THE GENERAL CUSTOMER SERVICE LINE;
3. ESTABLISH A DIRECT E–MAIL ADDRESS FOR
INQUIRIES ON THE UNIFORM CREDENTIALING FORM THAT IS MONITORED BY THE
CARRIER AND IS NOT THE GENERAL CUSTOMER SERVICE E–MAIL ADDRESS; AND
4. RESPOND TO VOICE MESSAGES RECEIVED AT THE
TELEPHONE NUMBER ESTABLISHED UNDER ITEM 2 OF THIS SUBPARAGRAPH AND
E–MAILS RECEIVED AT THE E–MAIL ADDRESS ESTABLISHED UNDER ITEM 3 OF THIS
SUBPARAGRAPH WITHIN 2 BUSINESS DAYS AFTER RECEIPT OF THE VOICE MESSAGE
OR E–MAIL.
(n) (1) A carrier shall make the carrier’s provider directory available to
prospective enrollees on the Internet and, on request of a prospective enrollee, in printed
form.
(2) The carrier’s provider directory on the Internet shall be available:
(i) through a clear link or tab; and
(ii) in a searchable format.
(3) The provider directory shall include:
(i) for each provider on the carrier’s provider panel:
1. the name of the provider;
2. the specialty areas of the provider;
3. whether the provider currently is accepting new patients;
4. for each office of the provider where the provider
participates on the provider panel:
A. its location, including its address; and
B. contact information for the provider;
5. the gender of the provider, if the provider notifies the
carrier or the multi–carrier common online provider directory information system
designated under § 15–112.3 of this subtitle of the information; and
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Ch. 706 2026 LAWS OF MARYLAND
6. any languages spoken by the provider other than English,
if the provider notifies the carrier or the multi–carrier common online provider directory
information system designated under § 15–112.3 of this subtitle of the information;
(ii) for each health care facility in the carrier’s network:
1. the health care facility’s name;
2. the health care facility’s address;
3. the types of services provided by the health care facility;
and
4. contact information for the health care facility; and
(iii) a statement that advises enrollees and prospective enrollees to
contact a provider or a health care facility before seeking treatment or services, to confirm
the provider’s or health care facility’s participation in the carrier’s network and the
enrollee’s health benefit plan.
(o) (1) A carrier shall have a customer service telephone number, e–mail
address link, or other electronic means by which enrollees and prospective enrollees may
notify the carrier of inaccurate information in the carrier’s network directory.
(2) If notified of a potential inaccuracy in a network directory by a person
other than the provider, a carrier shall investigate the reported inaccuracy and take
corrective action, if necessary, to update the network directory within 45 working days after
receiving the notification.
(p) (1) A carrier shall notify each enrollee at the time of initial enrollment and
renewal about how to access or obtain the information required under subsection (n) of this
section.
(2) (i) 1. Information provided in printed form under subsection (n)
of this section shall be accurate on the date of publication.
2. A carrier shall update the information provided in printed
form at least once a year.
(ii) 1. Information provided on the Internet under subsection (n)
of this section shall be accurate on the date of initial posting and any update.
2. In addition to the requirement to update its provider
information under subsection (t)(1) of this section, a carrier shall update the information
provided on the Internet at least once every 15 days.
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WES MOORE, Governor Ch. 706
(3) (I) A CARRIER SHALL USE THE ONLINE CREDENTIALING
SYSTEM AS THE PRIMARY SOURCE OF INFORMATION TO CREATE AND UPDATE THE
CARRIER’S PROVIDER DIRECTORY IN ACCORDANCE WITH REGULATIONS ADOPTED
BY THE COMMISSIONER.
(II) THE COMMISSIONER SHALL ADOPT REGULATIONS
GOVERNING THE USE BY A CARRIER OF THE ONLINE CREDENTIALING SYSTEM TO
CREATE AND UPDATE THE CARRIER’S PROVIDER DIRECTORY, INCLUDING THE
REQUIRED FREQUENCY OF UPDATES.
[(3)] (4) [A] IN ADDITION TO UPDATES REQUIRED UNDER
PARAGRAPH (3) OF THIS SUBSECTION, A carrier shall:
(i) 1. periodically review at least a reasonable sample size of its
provider directory for accuracy; and
2. retain documentation of the review and make the review
available to the Commissioner on request; or
(ii) contact providers listed in the carrier’s provider directory who
have not submitted a claim in the last 6 months to determine if the providers intend to
remain in the carrier’s provider network.
[(4)] (5) A carrier shall demonstrate the accuracy of the information
provided under paragraph [(3)] (4) of this subsection on request of the Commissioner.
[(5)] (6) A carrier shall include in a provider directory that is in printed
form a statement notifying a reader that:
(i) the information contained in the provider directory is accurate as
of the date of publication; and
(ii) to obtain the most current information, the individual should
consult the provider directory on the Internet or contact the carrier directly.
[(6)] (7) Before imposing a penalty against a carrier for inaccurate
network directory information, the Commissioner shall take into account, in addition to
any other factors required by law, whether:
(i) the carrier afforded a provider or other person identified in [§
15–112.3(c)] § 15–112.3(D) of this subtitle an opportunity to review and update the
provider’s network directory information:
1. through the multi–carrier common online provider
directory information system designated under § 15–112.3 of this subtitle; or
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Ch. 706 2026 LAWS OF MARYLAND
2. directly with the carrier;
[(ii) the carrier can demonstrate the efforts made, in writing,
electronically, or by telephone, to obtain updated network directory information from a
provider or other person identified in § 15–112.3(c) of this subtitle;]
[(iii)] (II) the carrier has contacted a provider listed in the carrier’s
network directory who has not submitted a claim in the last 6 months to determine if the
provider intends to remain on the carrier’s provider panel;
[(iv)] (III) the carrier includes in its network directory the last date
that a provider updated the provider’s information;
[(v)] (IV) the carrier has implemented any other process or
procedure to:
1. INFORM PROVIDERS THAT THE ONLINE
CREDENTIALING SYSTEM IS THE PRIMARY SOURCE OF INFORMATION TO CREATE
AND UPDATE THE CARRIER’S PROVIDER DIRECTORY;
[1.] 2. encourage providers to update their network directory
information; or
[2.] 3. increase the accuracy of its network directory; and
[(vi)] (V) a provider or other person identified in [§ 15–112.3(c)] §
15–112.3(D) of this subtitle has not updated the provider’s network directory information,
despite opportunities to do so.
(t) (1) [(i) Subject to subparagraph (ii) of this paragraph, a] A carrier shall
update the information that must be made available on the Internet under subsection (n)
of this section within 2 working days after receipt of electronic notification or notification
by first–class mail tracking method from the participating provider of a change in the
applicable information.
[(ii) A dental carrier shall update the information required by this
subsection within 15 working days after receipt of the notification described in
subparagraph (i) of this paragraph.]
(2) Notification is presumed to have been received by a carrier:
(i) 3 working days after the date the participating provider placed
the notification in the U.S. mail, if the participating provider maintains the stamped
certificate of mailing for the notice; or
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WES MOORE, Governor Ch. 706
(ii) on the date recorded by the courier, if the notification was
delivered by courier.
(u) (1) A carrier may not require a provider that provides health care services
through a group practice or health care facility that participates on the carrier’s provider
panel under a contract with the carrier to be considered a participating provider or accept
the reimbursement fee schedule applicable under the contract when:
(i) providing health care services to enrollees of the carrier through
an individual or group practice or health care facility that does not have a contract with the
carrier; and
(ii) billing for health care services provided to enrollees of the carrier
using a different federal tax identification number than that used by the group practice or
health care facility under a contract with the carrier.
(2) A nonparticipating provider shall notify an enrollee:
(i) that the provider does not participate on the provider panel of
the enrollee’s carrier; and
(ii) of the anticipated total charges for the health care services.
(w) (1) Notwithstanding subsection (u)(1) of this section, a carrier shall
reimburse a group practice on the carrier’s provider panel at the participating provider rate
for covered services provided by a provider who is not a participating provider if:
(i) the provider is employed by or a member of the group practice;
(ii) the provider has applied for acceptance on the carrier’s provider
panel and the carrier has notified the provider of the carrier’s intent to continue to process
the provider’s application to obtain necessary credentialing information;
(iii) the provider has a valid license issued by a health occupations
board to practice in the State; and
(iv) the provider:
1. is currently credentialed by an accredited hospital in the
State; [or]
2. has professional liability insurance; OR
3. HAS IMMUNITY UNDER THE FEDERAL TORT CLAIMS
ACT OR THE MARYLAND TORT CLAIMS ACT.
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Ch. 706 2026 LAWS OF MARYLAND
(2) A carrier shall reimburse a group practice on the carrier’s provider
panel in accordance with paragraph (1) of this subsection from the date the notice required
under subsection (g)(3)(i)1 of this section is sent to the provider until the date the notice
required under subsection (g)(3)(iii)2 of this section is sent to the provider.
(3) A carrier that sends written notice of rejection of a provider for
credentialing under subsection (g)(3)(iii)2 of this section shall reimburse the provider as a
nonparticipating provider for covered services provided on or after the date the notice is
sent.
(4) A health maintenance organization may not deny payment to a provider
under this subsection solely because the provider was not a participating provider at the
time the services were provided to an enrollee.
(5) A provider who is not a participating provider of a carrier and whose
group practice is eligible for reimbursement under paragraph (1) of this subsection may not
hold an enrollee of the carrier liable for the cost of any covered services provided to the
enrollee during the time period described in paragraph (2) of this subsection, except for any
deductible, copayment, or coinsurance amount owed by the enrollee to the group practice
or provider under the terms of the enrollee’s contract or certificate.
(6) A group practice shall disclose in writing to an enrollee at the time
services are provided that:
(i) the treating provider is not a participating provider;
(ii) the treating provider has applied to become a participating
provider;
(iii) the carrier has not completed its assessment of the qualifications
of the treating provider to provide services as a participating provider; and
(iv) any covered services received must be reimbursed by the carrier
at the participating provider rate.
(x) A carrier may not impose a limit on the number of [behavioral health
providers at a health care facility] THE FOLLOWING that may be credentialed to
participate on a provider panel:
(1) BEHAVIORAL HEALTH PROVIDERS AT A HEALTH CARE FACILITY;
(2) PROVIDERS AT A FEDERALLY QUALIFIED HEALTH CENTER;
(3) PROVIDERS AT A LOCAL HEALTH DEPARTMENT;
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WES MOORE, Governor Ch. 706
(4) PROVIDERS AT A SCHOOL–BASED HEALTH CENTER; OR
(5) OTHER ESSENTIAL COMMUNITY PROVIDERS.
15–112.1.
(a) (1) In this section the following words have the meanings indicated.
(2) (i) “Carrier” means:
1. an insurer;
2. a nonprofit health service plan;
3. a health maintenance organization;
4. a dental plan organization;
5. a managed care organization; or
6. any other person that provides health benefit plans
subject to regulation by the State.
(ii) “Carrier” includes an entity that arranges a provider panel for a
carrier.
(3) “Credentialing intermediary” means a person to whom a carrier has
delegated credentialing or recredentialing authority and responsibility.
(4) “Health care provider” means an individual who is licensed, certified,
or otherwise authorized under the Health Occupations Article to provide health care
services.
(5) “Provider panel” means the providers that contract with a carrier to
provide health care services to the enrollees under a health benefit plan of the carrier.
(6) “Uniform credentialing form” means the form designated by the
Commissioner for use by a carrier or its credentialing intermediary for credentialing and
recredentialing a health care provider for participation on a provider panel.
(b) (1) Except as provided in subsection (c) of this section, a carrier or its
credentialing intermediary shall accept the uniform credentialing form as the sole
application for a health care provider to become credentialed or recredentialed for a
provider panel of the carrier.
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Ch. 706 2026 LAWS OF MARYLAND
(2) A carrier or its credentialing intermediary shall make the uniform
credentialing form available to any health care provider that is to be credentialed or
recredentialed by that carrier or credentialing intermediary.
(c) The requirements of subsection (b) of this section do not apply to a hospital or
academic medical center that:
(1) is a participating provider on the carrier’s provider panel; and
(2) acts as a credentialing intermediary for that carrier for health care
practitioners that:
(i) participate on the carrier’s provider panel; and
(ii) have privileges at the hospital or academic medical center.
(d) The Commissioner may impose a penalty not to exceed $500 against any
carrier for each violation of this section by the carrier or its credentialing intermediary.
(e) (1) The Commissioner may adopt regulations to implement the provisions
of this section.
(2) The Commissioner may designate a provider credentialing application
developed by a nonprofit alliance of health plans and trade associations for an online
credentialing system offered to carriers and providers as the uniform credentialing form if:
(i) the provider credentialing application is available to providers at
no charge; and
(ii) use of the provider credentialing application is not conditioned
on submitting the provider credentialing application to a carrier through the online
credentialing system;
(III) THE SYSTEM ALLOWS PROVIDERS TO:
1. GRANT ACCESS TO A DESIGNATED PERSON MANAGING
THE CREDENTIALING PROCESS FOR THE PROVIDER; AND
2. ACCESS THE SYSTEM DIRECTLY WITHOUT THE
ASSISTANCE OF A THIRD PARTY; AND
(IV) THE VENDOR:
1. ESTABLISHES AND MAINTAINS A STAKEHOLDER
WORKGROUP TO IDENTIFY AND ADDRESS OPERATIONAL ISSUES TO ENSURE
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WES MOORE, Governor Ch. 706
EFFICIENCY OF THE ONLINE CREDENTIALING SYSTEM CONSISTING OF
REPRESENTATIVES OF:
A. HEALTH AND DENTAL CARRIERS;
B. MANAGED CARE ORGANIZATIONS;
C. COMMUNITY HEALTH CENTERS, INCLUDING
FEDERALLY QUALIFIED HEALTH CENTERS;
D. BEHAVIORAL HEALTH PROVIDERS;
E. PRIVATE PRACTICES OF PHYSICIANS, DENTISTS,
ADVANCE PRACTICE CLINICIANS, AND OTHER CLINICIANS; AND
F. CREDENTIALING INTERMEDIARIES;
2. SUBMITS A REPORT TO THE COMMISSIONER BY
SEPTEMBER 1 EACH YEAR ON:
A. THE FINDINGS OF THE WORKGROUP ESTABLISHED
UNDER ITEM 1 OF THIS ITEM AND IMPROVEMENTS IMPLEMENTED AS A RESULT OF
THE WORKGROUP’S FINDINGS; AND
B. FOR EACH CARRIER, THE CALCULATION OF THE
AVERAGE NUMBER OF DAYS BETWEEN THE DATE THE CARRIER RECEIVES A
COMPLETED CREDENTIALING APPLICATION AND THE DATE THE CARRIER SENDS
WRITTEN NOTICE TO THE PROVIDER OF THE ACCEPTANCE OR REJECTION OF THE
APPLICATION; AND
3. MEETS ALL OTHER REQUIREMENTS ESTABLISHED BY
THE COMMISSIONER.
(3) ON OR BEFORE DECEMBER 1 EACH YEAR, BEGINNING IN 2027,
THE COMMISSIONER SHALL REPORT TO THE GENERAL ASSEMBLY, IN ACCORDANCE
WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, ON:
(I) THE FINDINGS OF THE WORKGROUP ESTABLISHED UNDER
PARAGRAPH (2)(IV)1 OF THIS SUBSECTION;
(II) IMPROVEMENTS IMPLEMENTED AS A RESULT OF THE
WORKGROUP’S FINDINGS;
(III) ANY LEGISLATIVE RECOMMENDATIONS; AND
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Ch. 706 2026 LAWS OF MARYLAND
(IV) ANY OTHER RELEVANT INFORMATION.
15–112.3.
(a) (1) In this section the following words have the meanings indicated.
(2) (i) “Carrier” has the meaning stated in § 15–112 of this subtitle.
(ii) “Carrier” does not include a managed care organization, as
defined in Title 15, Subtitle 1 of the Health – General Article.
(3) “Multi–carrier common online provider directory information system”
means the system designated by the Commissioner for use by providers to provide and
update their provider directory information with carriers.
(b) The Commissioner may designate a multi–carrier common online provider
directory information system developed by a nonprofit alliance of health plans and trade
associations if:
(1) the system is available to providers nationally;
(2) the system is available to providers at no charge;
(3) the system allows providers to:
(i) attest online to the accuracy of their information; [and]
(ii) [1. correct any inaccurate information; and
2. attest to the correction] UPDATE THE PROVIDER’S
INFORMATION EVERY 120 DAYS OR AT A FREQUENCY ESTABLISHED BY THE
COMMISSIONER;
(III) GRANT ACCESS TO A DESIGNATED PERSON MANAGING THE
CREDENTIALING PROCESS FOR THE PROVIDER; AND
(IV) ACCESS THE SYSTEM DIRECTLY WITHOUT THE ASSISTANCE
OF A THIRD PARTY; and
(4) (2) the nonprofit alliance: VENDOR
(I) has a well–established mechanism for outreach to providers.;
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WES MOORE, Governor Ch. 706
(II) ESTABLISHES AND MAINTAINS A STAKEHOLDER
WORKGROUP TO IDENTIFY AND ADDRESS OPERATIONAL ISSUES TO ENSURE
EFFICIENCY OF THE ONLINE CREDENTIALING SYSTEM CONSISTING OF
REPRESENTATIVES OF:
1. HEALTH AND DENTAL CARRIERS;
2. MANAGED CARE ORGANIZATIONS;
3. COMMUNITY HEALTH CENTERS, INCLUDING
FEDERALLY QUALIFIED HEALTH CENTERS;
4. BEHAVIORAL HEALTH PROVIDERS;
5. PRIVATE PRACTICES OF PHYSICIANS, DENTISTS,
ADVANCED PRACTICE CLINICIANS, AND OTHER CLINICIANS; AND
6. CREDENTIALING INTERMEDIARIES;
(III) SUBMITS A REPORT TO THE COMMISSIONER BY SEPTEMBER
1 EACH YEAR ON THE FINDINGS OF THE WORKGROUP ESTABLISHED UNDER ITEM (II)
OF THIS ITEM AND IMPROVEMENTS IMPLEMENTED AS A RESULT OF THE
WORKGROUP’S FINDINGS; AND
(IV) MEETS ALL OTHER REQUIREMENTS ESTABLISHED BY THE
COMMISSIONER.
(C) ON OR BEFORE DECEMBER 1 EACH YEAR, BEGINNING IN 2027, THE
COMMISSIONER SHALL REPORT TO THE GENERAL ASSEMBLY, IN ACCORDANCE
WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, ON:
(1) THE FINDINGS OF THE WORKGROUP ESTABLISHED UNDER
SUBSECTION (B)(4)(II) OF THIS SECTION;
(2) IMPROVEMENTS IMPLEMENTED AS A RESULT OF THE
WORKGROUP’S FINDINGS;
(3) ANY LEGISLATIVE RECOMMENDATIONS; AND
(4) ANY OTHER RELEVANT INFORMATION.
[(c)] (D) A carrier shall accept new and updated provider directory information
for a provider submitted:
– 17 –
Ch. 706 2026 LAWS OF MARYLAND
(1) (i) through the multi–carrier common online provider directory
information system; or
(ii) directly to the carrier; and
(2) from:
(i) the provider;
(ii) a hospital or academic medical center that:
1. is a participating provider on the carrier’s provider panel;
and
2. acts as a credentialing intermediary for the carrier for
providers that:
A. participate on the carrier’s provider panel; and
B. have privileges at the hospital or academic medical center;
or
(iii) any other person that performs credentialing functions on behalf
of a provider.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2026 January 1, 2027.
Approved by the Governor, May 26, 2026.
– 18 –Every fact on this page links to its source, starting with the official bill record.