HARRY HUGHES, Governor

3123

CHAPTER 816

(House Bill 1729)

AN ACT concerning

Health Maintenance Organization - Standards for Quality of Care

FOR the purpose of requiring the Secretary of Health and Mental
Hygiene to adopt regulations to set out certain standards of
quality of care for health maintenance organizations;
requiring the standards to include certain requirements;
requiring the State Insurance Commissioner to notify the
Department of Health and Mental Hygiene about certain fiscal
determinations concerning a health maintenance organization;
requiring the health maintenance organizations to provide
certain services to its members; requiring a health
maintenance organization to prepare a certain plan that
includes certain information; requiring a health maintenance
organization to have an internal peer review system to
evaluate its utilization and quality of health care
services; requiring the Department to conduct an external
review of the quality of the health care services; providing
for the composition of the external review; providing for
the external review to consist of certain evaluations;
prohibiting a health maintenance organization from failing
to provide certain services to its members in a timely
manner; requiring the Commissioner to notify the Department
of certain determinations; requiring the Department to
monitor certain health maintenance organizations under
specified conditions; and generally relating to the
standards of quality of care for a health maintenance
organization.

BY adding to

Article - Health - General

Section 19-705.1, 19-728(c), and 19-729(a)(9)

Annotated Code of Maryland

(1982 Volume and 1985 Supplement)

BY repealing and reenacting, with amendments,

Article - Health - General

Section 19-710(f), 19-729(a)(7) and (8), and 19-730

Annotated Code of Maryland

(1982 Volume and 1985 Supplement)

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:

Article - Health - General