WILLIAM DONALD SCHAEFER, Governor Ch. 188

(3) THE INDIVIDUAL HAS HELD A DIRECT PAY HEALTH
INSURANCE POLICY FOR AT LEAST 6 MONTHS OR IS ELIGIBLE FOR
CONTINUATION OF BENEFITS THROUGH THE FORMER EMPLOYER AND
THE PROVISIONS OF THE CONSOLIDATED OMNIBUS BUDGET
RECONCILIATION ACT OF 1985, P.L. 99-272, ARTICLE 48A. 351T, 354GG, 177K,
190 I, AND THE CODE OF MARYLAND REGULATIONS 09.30.61 AND 09.30.81
AND ANY SUBSEQUENT MODIFICATIONS TO THE ACT;

(4) THE INDIVIDUAL IS NOT ELIGIBLE FOR HEALTH
INSURANCE THROUGH ANOTHER FAMILY MEMBER; AN0

(5) A PHYSICIAN CERTIFIES THAT THE INDIVIDUAL IS:

(I) HIV POSITIVE; AND

(II) DUE TO THIS ILLNESS, THE INDIVIDUAL IS EITHER
TOO ILL TO CONTINUE WORKING IN THE INDIVIDUAL'S CURRENT
POSITION, OR THERE IS A SUBSTANTIAL LIKELIHOOD THAT WITHIN 3
MONTHS THE INDIVIDUAL WILL BE UNABLE TO WORK; AND

(6) THE INDIVIDUAL IS A RESIDENT OF THE STATE.

15-203.

(A) THE DEPARTMENT SHALL ADOPT REGULATIONS FOR THE
PAYMENT OF HEALTH INSURANCE PREMIUMS TO INSURANCE CARRIERS
OR EMPLOYERS UNDER THE PROGRAM.

(B) THE PROGRAM SHALL PAY 100 PERCENT OF THE COST OF THE
INDIVIDUAL'S HEALTH INSURANCE PREMIUM AND UP TO 2 PERCENT
ADDITIONAL REIMBURSEMENT TO EMPLOYERS FOR ADMINISTRATIVE
GOSTS IN ACCORDANCE WITH THE PROVISIONS OF THE CONSOLIDATED
OMNIBUS BUDGET RECONCILIATION ACT OF 1985, P.L. 99-272, AND ANY
SUBSEQUENT MODIFICATIONS TO THE ACT.

15-204.

THE DEPARTMENT SHALL ADOPT REGULATIONS THAT AUTHORIZE
THE DENIAL, RESTRICTION, OR TERMINATION OF BENEFITS FOR
RECIPIENTS WHO COMMIT ACTS OF ABUSE OR FRAUD AGAINST THE
PROGRAM.

15-205.

(A) THE DEPARTMENT SHALL, SUBJECT TO § 2-2322 OF THE STATE
GOVERNMENT ARTICLE, PROVIDE THE GOVERNOR AND THE GENERAL
ASSEMBLY WITH AN ANNUAL REPORT SUMMARIZING THE PROGRAM
EXPENDITURES, NUMBERS OF RECIPIENTS, PROGRAM EFFECTIVENESS,
AND THE ESTIMATED SAVINGS TO THE MEDICAL ASSISTANCE PROGRAM^
ADDITIONAL COSTS INCURRED BY PRIVATE INSURANCE COMPANIES, AND
THE LOSS OF FEDERAL FUNDING.

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