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ROBERT L. EHRLICH, JR., Governor
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Ch. 172
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Annotated Code of Maryland
(2002 Replacement Volume and 2004 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:
Article - Health - General
19-703.1.
(b) (1) Subject to the provisions of this section, each contract or certificate
issued to a member or subscriber by a health maintenance organization that provides
health benefits and services for diseases may not discriminate against any person
with a mental illness, emotional disorder or a drug abuse or alcohol abuse disorder by
failing to provide benefits for treatment and diagnosis of these illnesses under the
same terms and conditions as provided for covered benefits offered under the contract
or certificate for the treatment of physical illness.
(2) It shall not be considered to be discriminatory under paragraph (1) of
this subsection if at least the following benefits are provided:
(i) With respect to inpatient benefits provided in a licensed or
certified facility, which shall include hospital inpatient benefits, the total number of
days for which benefits are payable shall be:
1. Except as provided in subsection (d) of this section, from
July 1, 1994 through June 30, 1995, at least 60 days in any calendar year or benefit
period of not more than 12 months under the same terms and conditions that apply to
benefits available under the contract or certificate for physical illness; and
2. On or after July 1, 1995, at least equal to the same terms
and conditions that apply to the benefits available under the contract or certificate for
physical illness;
(ii) Subject to subsection (f) of this section, with respect to benefits
for partial hospitalization, at least 60 days of partial hospitalization shall be covered
under the same terms and conditions that apply to the benefit available under the
contract or certificate for physical illness; and
(iii) With respect to outpatient coverage, other than for inpatient or
partial hospitalization services, benefits for covered expenses arising from services
which are rendered to treat mental illness, emotional disorders, drug abuse and
alcohol abuse shall be at a rate which is, after the applicable deductible, not less than:
1. 80 percent for the first 5 visits in any calendar year or
benefit period of not more than 12 months;
2. 65 percent for the 6th through 30th visit in any calendar
year or benefit period of not more than 12 months; and
3. 50 percent for the 31st visit and any visit after the 31st
visit in any calendar year or benefit period of not more than 12 months.
- 1095 -
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