MARVIN MANDEL, Governor

1381

HEALTH MAINTENANCE ORGANIZATIONS WHICH PROVIDE HEALTH
CARE SERVICES DIRECTLY TO SUBSCRIBERS OR GROUPS OF
SUBSCRIBERS WHO CONTRACT FOR THESE SERVICES UNDER A
SYSTEM OF PREPAYMENTS.

(B)    IN CARRYING OUT THIS INTENTION, THE POLICY OF
THE STATE IS TO:

(1)    PROVIDE ONE OVERALL STATE LAW FOR THE
REGULATION OF HEALTH MAINTENANCE ORGANIZATIONS, ALLOWING
FLEXIBILITY FOR THE MANY FORMS THEY MAY TAKE, THEREBY
FACILITATING THE UNIFORM ADMINISTRATION OF THE
REGULATIONS THAT ARE PROMULGATED PURSUANT TO THIS
SUBTITLE AND THE PUBLIC UNDERSTANDING OF THEM; AND

(2)    ELIMINATE LEGAL BARRIERS TO THE
ORGANIZATION, PROMOTION, AND EXPANSION OF PREPAID HEALTH
CARE PLANS; AND

(3)    PROVIDE FOR REGULATION OF THE FISCAL
ASPECTS OF THESE PLANS BY THE STATE INSURANCE
COMMISSIONER AND OF THE QUALITY OF HEALTH CARE BY THE
DEPARTMENT OF HEALTH AND MENTAL HYGIENE AND BY
PROFESSIONAL STANDARDS REVIEW ORGANIZATIONS WHERE
APPROPRIATE; AND

(4)    EXEMPT PREPAID HEALTH CARE PLANS FROM
THE OPERATION OF THE INSURANCE LAWS OF THE STATE, EXCEPT
TO THE EXTENT AND IN THE MANNER SET FORTH IN THIS
SUBTITLE.

(C)    THE INTENTION OF THE STATE IN ENACTING THIS
SUBTITLE IS TO ENCOURAGE THE FORMATION OF HEALTH
MAINTENANCE ORGANIZATIONS BY SUCH DIVERSE GROUPS AS
NONPROFIT HEALTH SERVICE PLANS; MEDICAL HEALTH SERVICE
PLANS; MEDICAL CARE FOUNDATIONS; GROUPS OF PROFESSIONALS,
EITHER IN THE FORM OF PARTNERSHIPS OR PROFESSIONAL
CORPORATIONS; CONSUMER SPONSORED ORGANIZATIONS; OR
BUSINESS OR LEGAL ENTITIES, PROVIDED THAT THEY MEET THE
NECESSARY MINIMUM QUALIFICATIONS UNDER THIS SUBTITLE.

842.

(A) A "HEALTH MAINTENANCE ORGANIZATION" MEANS ANY
ORGANIZATION, PERSON, MEDICAL CARE FOUNDATION, FIRM, OR
CORPORATION THAT OPERATES OR PROPOSES TO OPERATE IN
MARYLAND, INCLUDING A PROFIT OR NONPROFIT CORPORATION
ORGANIZED UNDER THE LAWS OF ANOTHER COUNTRY, STATE, OR
THE DISTRICT OF COLUMBIA, WHICH:

(1) PROVIDES OR OTHERWISE MAKES AVAILABLE TO
ITS MEMBERS HEALTH CARE SERVICES, AS DEFINED IN
SUBSECTION (C) OF THIS SECTION, INCLUDING, AT A MINIMUM,
PHYSICIAN, HOSPITALIZATION, LABORATORY, X-RAY, EMERGENCY