WILLIAM DONALD SCHAEFER, Governor                            Ch. 601

15-103.

(D) (1) IN THIS SUBSECTION, "ALCOHOL ABUSE AND DRUG ABUSE
TREATMENT PROGRAM" HAS THE MEANING STATED IN §8-403(A) OF THIS ARTICLE.

(2) FOR HEALTH MAINTENANCE ORGANIZATIONS UNDER CONTRACT
WITH THE SECRETARY TO PROVIDE SERVICES TO ELIGIBLE PROGRAM RECIPIENTS,
THE SECRETARY SHALL:

(I)      1. DEVELOP A PROCEDURE THAT WOULD ENABLE A
SUBSTANCE ABUSING PREGNANT WOMAN ENROLLED IN A HEALTH MAINTENANCE
ORGANIZATION TO DISENROLL FROM THE HEALTH MAINTENANCE ORGANIZATION
AND ENTER AN ALCOHOL ABUSE AND DRUG ABUSE TREATMENT PROGRAM
DURING THE SAME 24-HOUR PERIOD; OR

(II) 2. PROVIDE COVERAGE FOR ALCOHOL ABUSE AND DRUG
ABUSE TREATMENT PROGRAM SERVICES FOR A SUBSTANCE ABUSING PREGNANT
WOMAN THROUGH THE HEALTH MAINTENANCE ORGANIZATION; AND

(II)     DEVELOP A PROCEDURE TO PROVIDE. PRIOR TO ENROLLMENT IN
A HEALTH MAINTENANCE ORGANIZATION, NOTICE TO ELIGIBLE PROGRAM RECIPIENTS
OF THE PROVISIONS OF SUBPARAGRAPH (I) OF THIS PARAGRAPH.

SECTION 2. AND BE IT FURTHER ENACTED, That, notwithstanding any
provision of Article 48A of the Code and if authorized under federal law, the Secretary of
Health and Mental Hygiene through the adoption of regulations may establish a pilot program,
subject to the review of the Joint Committee on Health Care Delivery and Financing, to enter
into prepaid or capitated payment arrangements under which services are made available to
medical assistance recipients by health care providers that do not hold a certificate of authority
to operate as an insurer or a health maintenance organization. Any pilot program established
under this section shall be carefully controlled and monitored to ensure that medical assistance
recipients have continued access to needed services and shall include provisions to ensure that
participating providers have a demonstrated capacity to assume the financial risk under the
prepaid or capitated payment arrangement. Nothing in this section may be construed as
authorizing the Secretary to waive the provisions of § 15-110 of the Health - General Article.

SECTION 3. AND BE IT FURTHER ENACTED, That Section 2 of this Act is
contingent on the taking effect of Chapter ______ (H.B. 1359) of the Acts of the General

Assembly of 1993, and if Chapter ____ (H.B. 1359) does not become effective, Section 2 of

this Act shall be null and void without the necessity of further action by the General Assembly.

SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect
October July 1, 1993.

Approved May 27, 1993.

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