15-126.

(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.

(2) "BEHAVIORAL HEALTH CARE SERVICES" MEANS PROCEDURES OR
SERVICES RENDERED BY A HEALTH CARE PROVIDER FOR THE TREATMENT OF
MENTAL ILLNESS, EMOTIONAL DISORDERS, DRUG ABUSE, OR ALCOHOL ABUSE.

(3) "CARRIER" MEANS:

(I) A HEALTH INSURER;

(II) A NONPROFIT HEALTH SERVICE PLAN;

(III) A HEALTH MAINTENANCE ORGANIZATION;

(IV) A PREFERRED PROVIDER ORGANIZATION;

(V) A THIRD PARTY ADMINISTRATOR; OR

(VI) EXCEPT FOR A MANAGED CARE ORGANIZATION AS DEFINED IN
TITLE 15, SUBTITLE 1 OF THE HEALTH - GENERAL ARTICLE, ANY OTHER PERSON
THAT PROVIDES HEALTH BENEFIT PLANS SUBJECT TO REGULATION BY THE STATE.

(4) "DIRECT CARE EXPENSES" MEANS THE PAYMENT TO A HEALTH CARE
PROVIDER BY A MANAGED BEHAVIORAL HEALTH CARE ORGANIZATION FOR THE
PROVISION OF BEHAVIORAL HEALTH CARE SERVICES TO A MEMBER

(5) "DIRECT PAYMENTS" MEANS THE MONEY THAT A CARRIER
DISBURSES TO A MANAGED BEHAVIORAL HEALTH CARE ORGANIZATION FOR THE
PROVISION OF BEHAVIORAL HEALTH CARE SERVICES TO A MEMBER

(6) "MANAGED BEHAVIORAL HEALTH CARE, ORGANIZATION". MEANS A
COMPANY, ORGANIZATION, OR SUBSIDIARY THAT:

(I) CONTRACTS WITH A CARRIER TO PROVIDE, UNDERTAKE TO
ARRANGE, OR ADMINISTER BEHAVIORAL HEALTH CARE SERVICES TO MEMBERS; OR

(II) OTHERWISE MAKES BEHAVIORAL HEALTH CARE SERVICES
AVAILABLE TO MEMBERS THROUGH CONTRACTS WITH HEALTH CARE PROVIDERS.

(7) (I) "MEMBER" MEANS AN INDIVIDUAL ENTITLED TO BEHAVIORAL
HEALTH CARE SERVICES FROM A CARRIER OR A MANAGED BEHAVIORAL HEALTH
CARE ORGANIZATION UNDER A POLICY, PLAN, OR CERTIFICATE OR PLAN ISSUED OR
DELIVERED IN THE STATE.

(II) "MEMBER" INCLUDES A SUBSCRIBER

(8) "MENTAL HEALTH EXPENSE RATIO" MEANS THE RATIO OF THE
TOTAL INCURRED DIRECT CARE EXPENSES FOR BEHAVIORAL HEALTH CARE
SERVICES IN RELATION TO THE TOTAL DIRECT PAYMENTS FOR BEHAVIORAL
HEALTH CARE SERVICES.