On Sep. 6, MD INS updated reporting of adverse decisions, grievances
MD INS issued Bulletin 24-21 to notify carriers of updates to the required Reporting Form for Adverse Decisions and Grievances, due to passage of Bill HB 1337, Ch. 891.
Follows MD LEG Apr. 2024 bill re reporting of insurance claims data, see #207518.
Updated Requirements
Bill revised the requirement of carriers to submit information on a quarterly basis.
Carriers must also report the number of members entitled to health care benefits under a policy, plan, or certificate issued or delivered in the State by the carrier.
Also report the number of clean claims for reimbursement processed by the carrier.
Number of members reported should be based on enrolled members as of last day of the quarter, and is limited to membership and claims data for health benefit plans.
The updated form must be used beginning with the quarterly report applicable to the period Jul. 1, 2024 to Sep. 30, 2024, and the report is due on Oct. 30, 2024.
Carriers also advised that the changes related to HB 1337 (MD INS 15-10A-06), do not impact reporting for semi-annual clean claims required by COMAR 30.10.11.14.
Accordingly, carriers should complete those clean claims separately on MIA website.
Deadline
Report is due by Oct. 30, 2024.
Regulators
MD INS
Entity Types
Ins
Reference
Bul 24-21, Form, 9/6/2024; Citation: MD INS 15-10A-06;
