MD HB917

Carriers may only retroactively deny reimbursement for coordination of benefits issues within 18 months of payment, or for other reasons within 3 months of service (reduced from 6 months) if the provider has received prior training on billing protocols.

Carriers must provide written statements with supporting documents and calculations when retroactively denying reimbursement to health care providers.

Retroactive denials are prohibited based on service outcomes, and carriers must first have a conversation with the provider to hear their justification before denying reimbursement.

Carriers that retroactively deny reimbursement must develop training plans for health care providers on reimbursement protocols, billing standards, and compliance requirements.

Effective January 1, 2027, applying to all policies issued, delivered, or renewed in Maryland on or after that date.