(a) In adopting this subtitle, the General Assembly intends to:
(1) Provide alternative methods for the delivery of health care services to residents of this State, with a view toward achieving greater efficiency and economy in providing these services;
(2) Encourage the formation of health maintenance organizations that provide health care services to subscribers or groups of subscribers who contract for these services under a system of prepayments; and
(3) Encourage the formation of health maintenance organizations by such diverse groups as:
(i) Nonprofit health service plans;
(ii) Medical health service plans;
(iii) Medical care foundations;
(iv) Groups of professionals, either in the form of partnerships or professional corporations;
(v) Consumer sponsored organizations; or
(vi) Business or legal entities.
(b) To carry out the intent of subsection (a) of this section, the policy of this State is to:
(1) Provide one overall State law that:
(i) Regulates health maintenance organizations;
(ii) Allows flexibility for the many forms these health maintenance organizations may take; and
(iii) Facilitates public understanding and uniform administration of the rules and regulations that are adopted under this subtitle;
(2) Eliminate legal barriers to the organization, promotion, and expansion of health maintenance organizations;
(3) Provide for regulation of:
(i) The quality of health care, by the Department and by professional standards review organizations where appropriate; and
(ii) All other matters covered under this subtitle, by the Commissioner; and
(4) Exempt health maintenance organizations from the insurance laws of this State, except as set forth in this subtitle.
Structure Maryland Statutes
Title 19 - Health Care Facilities
Subtitle 7 - Health Maintenance Organizations
Section 19-702 - Declaration of Intent and Policy
Section 19-703 - Scope of Subtitle
Section 19-704 - Corporate Practice of Medicine
Section 19-705 - Rules and Regulations
Section 19-705.1 - Standards of Quality of Care
Section 19-705.2 - Complaints of Members and Subscribers
Section 19-705.3 - Centers for Disease Control and Prevention's Guidelines on Universal Precautions
Section 19-705.4 - Limitations on Covered Services and Visits
Section 19-705.5 - Coverage for Inherited Metabolic Disease
Section 19-705.6 - Emergency Services
Section 19-705.7 - Toll-Free Telephone Access
Section 19-705.8 - Health Maintenance Organization Quality Assurance Unit
Section 19-706 - Regulation; Applicability of Other Laws
Section 19-706.1 - Rehabilitation or Liquidation of Health Maintenance Organizations
Section 19-707 - Authorization to Operate
Section 19-708 - Applications for Certificates to Operate
Section 19-710 - Basic Requirements to Operate as a Health Maintenance Organization
Section 19-710.1 - Payment to Health Care Provider Not Under Written Contract
Section 19-710.2 - Point-of-Service Option
Section 19-712 - Powers and Authority of Health Maintenance Organization
Section 19-712.2 - Notice to Pharmacies of Change in Pharmaceutical Benefits
Section 19-712.4 - Prohibited Referrals
Section 19-712.5 - Reimbursement for Hospital Emergency Facility and Provider
Section 19-712.6 - Continuing Care Facility
Section 19-712.7 - Reimbursement to Community Health Resources
Section 19-713 - Rates and Contracts
Section 19-713.1 - Contracts Between Health Maintenance Organization and Subscribers
Section 19-713.2 - Administrative Service Provider Contracts
Section 19-713.3 - Administrative Service Contracting Provider
Section 19-713.4 - Providing Pharmaceutical Services
Section 19-713.5 - Uniform Consultation Referral Form
Section 19-713.6 - Drug Therapy Management
Section 19-714 - Marketing Documents
Section 19-715 - Application or Offer of Enrollment
Section 19-716 - Availability of Information to Members and General Public
Section 19-717 - Annual Reports
Section 19-719 - Health Care Services; Examination
Section 19-720 - Health Services Cost Review Commission
Section 19-721 - Expiration of Certificate of Authority
Section 19-722 - Refusal to Renew Certificate; Remedies
Section 19-723 - Supervision of Health Maintenance Organizations
Section 19-724 - Solicitation of Members
Section 19-725 - Cancellation of Enrollment
Section 19-726 - Prohibited Use of Certain Terms
Section 19-727 - Applicability of Tax Laws
Section 19-728 - Responsibilities of Department and Commissioner
Section 19-729 - Prohibited Acts; Remedies
Section 19-730 - Penalties -- Violation of 19-729 of This Subtitle
Section 19-731 - Penalties -- Violation of 19-705 and 19-705.1 of This Subtitle
Section 19-735 - Foreign Health Maintenance Organization Transferring Domicile to This State