# COMAR 31.10.44.07: COMAR 31.10.44.07. Provider-to-Enrollee Ratio Standards

> Maryland · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_07

## Section

- **Citation:** COMAR 31.10.44.07
- **Heading:** COMAR 31.10.44.07. Provider-to-Enrollee Ratio Standards
- **Jurisdiction:** Maryland
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Code of Maryland Regulations / Title 31 MARYLAND INSURANCE ADMINISTRATION / Subtitle 10 HEALTH INSURANCE — GENERAL / Chapter 44 Network Adequacy / COMAR 31.10.44.07

## Text

A. Except for a Group Model HMOs health benefit plan, the provider panel for each carrier shall meet the provider-to-enrollee ratio standards listed in §B of this regulation .
B. The provider-to-enrollee ratios shall be equivalent to at least 1 full-time physician, or as appropriate, another full-time provider for:
(1) 1,200 enrollees for primary care;
(2) 2,000 enrollees for pediatric care;
(3) 2,000 enrollees for obstetrical/gynecological care;
(4) 2,000 enrollees for mental health care or services; and
(5) 2,000 enrollees for substance use disorder care or services.
C. The ratios described in §B of this regulation shall be calculated based on:
(1) The number of enrollees covered under all health benefit plans issued by the carrier in Maryland that use that provider panel; and
(2) The number of providers in that provider panel with practicing locations:
(a) In Maryland; or
(b) Within the applicable maximum travel distance standard specified in Regulation .05 of this chapter outside the geographic boundaries of Maryland.
Cross References 31.10.44.04C(13) 31.10.44.09A 31.10.44.09B 31.10.44.11A(3)(b)

## Nearby sections

- [COMAR 31.10.44.01 COMAR 31.10.44.01. Scope](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_01.md)
- [COMAR 31.10.44.02 COMAR 31.10.44.02. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_02.md)
- [COMAR 31.10.44.03 COMAR 31.10.44.03. Network Adequacy Standards](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_03.md)
- [COMAR 31.10.44.04 COMAR 31.10.44.04. Filing and Content of Access Plan](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_04.md)
- [COMAR 31.10.44.05 COMAR 31.10.44.05. Travel Distance Standards](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_05.md)
- [COMAR 31.10.44.06 COMAR 31.10.44.06. Appointment Waiting Time Standards](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_06.md)
- [COMAR 31.10.44.07 COMAR 31.10.44.07. Provider-to-Enrollee Ratio Standards](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_07.md)
- [COMAR 31.10.44.08 COMAR 31.10.44.08. Telehealth](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_08.md)
- [COMAR 31.10.44.09 COMAR 31.10.44.09. Waiver Request Standards](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_09.md)
- [COMAR 31.10.44.10 COMAR 31.10.44.10. Confidential Information in Access Plans](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_10.md)
- [COMAR 31.10.44.11 COMAR 31.10.44.11. Network Adequacy Access Plan Executive Summary Form](https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_11.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_MD_COMAR_31_10_44_07. Check the current official text before relying on it. Not legal advice.