Maryland Statutes
Subtitle 7 - Health Maintenance Organizations
Section 19-702 - Declaration of Intent and Policy

(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

Maryland Statutes

Health - General

Title 19 - Health Care Facilities

Subtitle 7 - Health Maintenance Organizations

Section 19-701 - Definitions

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 19-709 - Initial Fees

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 19-711 - Issuance of Certificate of Authority; Merger, Consolidation, etc., With Domestic Health Maintenance Organization

Section 19-711.3 - Merger, Consolidation, or Acquisition of Health Maintenance Organization; Financing Money

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 19-732 - Appeal

Section 19-734 - Short Title

Section 19-735 - Foreign Health Maintenance Organization Transferring Domicile to This State