Section 15-1A-14 - [Effective Until 10/1/2024] Emergency services(a)(1) In this section the following words have the meanings indicated.(2) "Emergency medical condition" means a medical condition that manifests itself by acute symptoms of such severity, including severe pain, that the absence of immediate medical attention could reasonably be expected by a prudent layperson, who possesses an average knowledge of health and medicine, to result in a condition described in § 1867(e)(1) of the Social Security Act.(3) "Emergency services" means, with respect to an emergency medical condition: (i) a medical screening examination that is within the capability of the emergency department of a hospital or freestanding medical facility, including ancillary services routinely available to the emergency department to evaluate an emergency medical condition; or(ii) any other examination or treatment within the capabilities of the staff and facilities available at the hospital or freestanding medical facility that is necessary to stabilize the patient.(b) If a carrier provides or covers any benefits for emergency services in an emergency department of a hospital or freestanding medical facility, the carrier:(1) may not require an insured individual to obtain prior authorization for the emergency services; and(2) shall provide coverage for the emergency services regardless of whether the health care provider providing the emergency services has a contractual relationship with the carrier to furnish emergency services.(c) If a health care provider of emergency services does not have a contractual relationship with the carrier to provide emergency services, the carrier:(1) may not impose any administrative requirement or limitation on coverage that would be more restrictive than administrative requirements or limitations imposed on coverage for emergency services furnished by a health care provider with a contractual relationship with the carrier;(2) subject to § 14-205.2 of this article and § 19-710.1 of the Health - General Article, may not impose any cost-sharing amount greater than the amount imposed for emergency services furnished by a health care provider with a contractual relationship with the carrier; and(3) shall reimburse the health care provider at the reimbursement rate specified in subsection (d) of this section.(d) Except as provided in § 14-205.2 of this article and § 19-710.1 of the Health - General Article, a carrier shall reimburse a health care provider of emergency services that does not have a contractual relationship with the carrier the greater of:(1) the median amount negotiated with in-network providers for the emergency service, excluding any in-network copayment or coinsurance;(2) the amount for the emergency service calculated using the same method the health benefit plan generally uses to determine payments for out-of-network services, excluding any in-network copayment or coinsurance, without reduction for out-of-network cost-sharing that generally applies under the health benefit plan; or(3) the amount that would be paid under Medicare Part A or Part B for the emergency service, excluding any in-network copayment or coinsurance.Added by 2020 Md. Laws, Ch. 621, Sec. 1, eff. 5/8/2020.Added by 2020 Md. Laws, Ch. 620, Sec. 1, eff. 5/8/2020.This section is set out more than once due to postponed, multiple, or conflicting amendments.