Ch. 2

1994 LAWS OF MARYLAND

(F) NOTHING IN THIS SECTION SHALL BE CONSTRUED TO PROHIBIT
EXCEEDING THE MINIMUM BENEFITS REQUIRED UNDER. SUBSECTION (B)(2)(II) OF
THIS SECTION FOR ANY PARTIAL HOSPITALIZATION DAY THAT IS MEDICALLY
NECESSARY AND WOULD SERVE TO PREVENT INPATIENT HOSPITALIZATION.

Article - Health - General

19-703.1.                            :

(A)     (1) IN THIS SECTION THE FOLLOWING TERMS HAVE THE MEANINGS
INDICATED.                                                                           

(2)      "ALCOHOL ABUSE" HAS THE MEANING STATED IN § 8-101 OF THE
HEALTH—GENERAL THIS ARTICLE.

(3)      "DRUG ABUSE" HAS THE MEANING STATED IN § 8-101 OF THE
HEALTH—GENERAL THIS ARTICLE.

(4)      "MANAGED CARE SYSTEM" MEANS A METHOD THAT A CARRIER
USES TO REVIEW AND PREAUTHORIZE A TREATMENT PLAN THAT A HEALTH CARE
PRACTITIONER DEVELOPS FOR A COVERED PERSON USING A VARIETY OF COST
CONTAINMENT METHODS TO CONTROL UTILIZATION, QUALITY, AND CLAIMS.

(5)      "PARTIAL HOSPITALIZATION" MEANS THE PROVISION OF
MEDICALLY DIRECTED INTENSIVE OR INTERMEDIATE SHORT-TERM TREATMENT
FOR MENTAL ILLNESS, EMOTIONAL DISORDERS, DRUG ABUSE OR ALCOHOL ABUSE'
FOR A PERIOD OF LESS THAN 24 HOURS BUT MORE THAN 4 HOURS IN A DAY FOR A
MEMBER OR SUBSCRIBER IN A LICENSED OR CERTIFIED FACILITY OR PROGRAM.

(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
SUBSECTION (B)(1) OF THIS SECTION 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

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