What do the regulations require of Payers?
The regulations apply to payers with annual health care premiums of over $1 million dollars. The payer regulations have two major requirements. First, payers must be capable of accepting claims through a payer designated MHCC-certified EHN. This does not limit a payers selection of more than one EHN, it merely states that at least one EHN must be MHCC-certified. Payers must also submit an EDI Progress Report that will aid the Commission in tracking the progress of health care EDI in Maryland.
