Sec. 31.10.45.03. Travel Distance Standards  


Latest version.
  • A. Sufficiency Standards.

    (1) Using the zip code list on the Maryland Insurance Administration’s website, each provider panel of a carrier shall have within the geographic area served by the carrier’s network or networks, sufficient dentists, including specialty providers, and facilities to meet the maximum travel distance standards listed in the chart under §A(2) of this regulation for each type of geographic area measured from the enrollee’s place of residence.

    (2) Chart of Travel Distance Standards.

    Urban Area
    Maximum
    Distance
    (miles)
    Suburban Area
    Maximum
    Distance
    (miles)
    Rural Area
    Maximum
    Distance
    (miles)
    Provider type:
    General dentist 15 30 60
    Endodontic 30 45 75
    Orthodontics and dentofacial orthopedics 30 45 75
    Oral and maxillofacial pathology 30 45 75
    Oral and maxillofacial radiology 30 45 75
    Oral and maxillofacial surgery 30 45 75
    Pediatric dentistry 30 45 75
    Periodontic 30 45 75
    Prosthodontics 30 45 75

    B. Each provider panel of a carrier shall include at least 20 percent of the available essential community providers who provide dental services in each of the urban, rural, and suburban areas.