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PARRIS N. GLENDENING, Governor Ch. 569
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in the cause of action; requiring that a health maintenance organization that
includes a subrogation provision in its contract use in its rating methodology an
adjustment that reflects the subrogation and identify in its rate filing with, and
in an annual report to, the Maryland Insurance Administration all amounts
recovered through subrogation; providing that this Act does not allow a contract
to contain a provision allowing a health maintenance organization to recover
payments made under a personal injury protection policy; providing for the
applicability of this Act; making provisions of this Act severable; and generally
relating to contracts between health maintenance organizations and subscribers
or groups of subscribers.
BY repealing and reenacting, with amendments,
Article - Health - General
Section 19-713(b) and 19-713.1
Annotated Code of Maryland
(1996 Replacement Volume and 1999 Supplement)
BY repealing and reenacting, with amendments,
Article - Insurance
Section 15-1205(d)
Annotated Code of Maryland
(1997 Volume and 1999 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:
Article - Health - General
19-713.
(b) (1) Rates of a health maintenance organization may not be excessive,
inadequate, or unfairly discriminatory in relation to the services offered.
(2) A HEALTH MAINTENANCE ORGANIZATION THAT INCLUDES A
SUBROGATION PROVISION IN ITS CONTRACT AS AUTHORIZED UNDER § 19-713.1(D) OF
THIS SUBTITLE SHALL:
(I) USE IN ITS RATING METHODOLOGY AN ADJUSTMENT THAT
REFLECTS THE SUBROGATION; AND
(II) IDENTIFY IN ITS RATE FILING WITH THE MARYLAND
INSURANCE ADMINISTRATION, AND ANNUALLY IN A FORM APPROVED BY THE
INSURANCE COMMISSIONER ALL AMOUNTS RECOVERED THROUGH SUBROGATION.
19-713.1.
(a) A contract between a health maintenance organization and its subscribers
or a group of subscribers may contain nonduplication provisions or provisions to
coordinate the coverage with subscriber contracts of other health maintenance
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- 3019 -
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