(a) A health maintenance organization may not:
(1) Violate any provision of this subtitle or any rule or regulation adopted under it;
(2) Fail to fulfill its obligations to provide the health care services specified in its contracts with subscribers;
(3) Make any false statement with respect to any report or statement required by this subtitle or by the Commissioner under this subtitle;
(4) Advertise, merchandise, or attempt to merchandise its services in a way that misrepresents its services or capacity for service;
(5) Engage in a deceptive, misleading, unfair, or unauthorized practice as to advertising or merchandising;
(6) Prevent or attempt to prevent the Commissioner or the Department from performing any duty imposed by this subtitle;
(7) Fraudulently obtain or fraudulently attempt to obtain any benefit under this subtitle;
(8) Fail to fulfill the basic requirements to operate as a health maintenance organization as provided in § 19-710 of this subtitle;
(9) Violate any applicable provision of Title 15, Subtitle 12 of the Insurance Article;
(10) Fail to provide services to a member in a timely manner as provided in § 19-705.1(b)(1) of this subtitle;
(11) Fail to comply with the provisions of Title 15, Subtitle 10A, 10B, 10C, or 10D or § 2-112.2 of the Insurance Article; or
(12) Violate any provision of § 19-712.5 of this subtitle.
(b) If any health maintenance organization violates this section, the Commissioner may pursue any one or more of the courses of action described in § 19-730 of 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