Ch. 9

1993 LAWS OF MARYLAND

(I) EACH MEMBER OF THE COMMISSION IS ENTITLED TO REIMBURSEMENT
FOR EXPENSES UNDER THE STANDARD STATE TRAVEL REGULATIONS, AS
PROVIDED IN THE STATE BUDGET.

(J) THE COMMISSION MAY EMPLOY A STAFF IN ACCORDANCE WITH THE
STATE BUDGET.

(K) THE STATE HAS NO PECUNIARY LIABILITY FOR ANY ACT PERFORMED OR
REQUIRED OR PERMITTED TO BE PERFORMED BY THE COMMISSION.

701.

(A)     (1) THE COMMISSION SHALL SPECIFY THE UNIFORM SET OF EFFECTIVE
BENEFITS TO APPLY UNDER THIS SUBTITLE.

(2) IN ESTABLISHING BENEFITS, THE COMMISSION SHALL JUDGE
PREVENTIVE SERVICES, MEDICAL TREATMENTS, PROCEDURES, AND RELATED
HEALTH SERVICES BASED ON:

(I) THEIR EFFECTIVENESS IN IMPROVING THE HEALTH STATUS OF
INDIVIDUALS; AND

(II) THEIR LONG-TERM IMPACT ON MAINTAINING AND

IMPROVING HEALTH AND PRODUCTIVITY AND ON REDUCING THE CONSUMPTION
OF HEALTH CARE SERVICES.

(3) THE COMMISSION MAY EXCLUDE ANY BENEFIT MANDATED UNDER
ARTICLE 48A OF THE CODE.

(B)     A HEALTH BENEFIT PLAN SHALL INCLUDE UNIFORM DEDUCTIBLES AND
COST SHARING ASSOCIATED WITH ITS BENEFITS, AS DETERMINED BY THE
COMMISSION.

(C) IN ESTABLISHING COST-SHARING AS PART OF THE UNIFORM EFFECTIVE
BENEFITS, THE COMMISSION SHALL:

(1) INCLUDE COST-SHARING THAT WILL RESTRAIN CONSUMERS FROM
SEEKING UNNECESSARY SERVICES;

(2) BALANCE THE EFFECT OF THE COST SHARING IN REDUCING
PREMIUMS AND IN AFFECTING UTILIZATION OF APPROPRIATE SERVICES; AND

(3) LIMIT THE TOTAL COST SHARING THAT MAY BE INCURRED BY AN
INDIVIDUAL IN A YEAR.

(D) (1) EXCEPT AS PROVIDED IN PARAGRAPH (3) OR (1) OF THIS
SUBSECTION, CARRIERS MAY LIMIT COVERAGE UNDER ANY HEALTH BENEFIT PLAN
UNDER A PREEXISTING CONDITION PROVISION, BUT ONLY FOR A PERIOD NOT
EXCEEDING 6 MONTHS FROM THE EFFECTIVE DATE OF COVERAGE FOR ANY
ENROLLEE, FOR ANY PREEXISTING CONDITION THAT EXISTED WITHIN THE 6
MONTHS PRECEDING THE DATE OF COVERAGE FOR THE ENROLLEE UNDER THE
PROGRAM.

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