Maryland Insurance Administration v. Maryland Individual Practice Ass'n

EYLER, Judge.

The two-part issue presented by this appeal, one of first impression, is whether (1) claims for payment submitted by a health care provider to a health maintenance organization (“HMO”) that are subject to a pending workers’ compensation claim are “payable by workers’ compensation” within the meaning of an exclusion in the health plan and (2) whether, *352pursuant to Md.Code (1996 Repl.Vol., 1998 Cum.Supp.) §§ 19-710.1 and 19-712.1 of the Health-General II Article, they must be paid within thirty days regardless of the answer to (1). We hold that a claim comes within such an exclusion…