Ch. 333                                    1995 LAWS OF MARYLAND

BY repealing and reenacting, with amendments,
Article - Health - General
Section 19-701(f) and 19-703
Annotated Code of Maryland
(1990 Replacement Volume and 1994 Supplement)

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:

Article - Health - General

19-701.

(a)     In this subtitle the following words have the meanings indicated.

(b)     "Benefit package" means a set of health care services to be provided to a
member of a health maintenance organization under a contract that entitles the member
to the health care services, whether the services are provided:

(1)     Directly by a health maintenance organization; or

(2)     Through a contract or arrangement with another person.

(f) "Health maintenance organization" means any person, including a profit or
nonprofit corporation organized under the laws of any state or country, that:

(1)     Operates or proposes to operate in this State;

(2)     Except as provided in § 19-703(b) AND (F) of this subtitle [with respect
to hospitalization services], provides or otherwise makes available to its members health
care services that include at least physician, hospitalization, laboratory, X-ray,
emergency, and preventive services, out-of-area coverage, and any other health care
services that the Commissioner determines to be available generally on an insured or
prepaid basis in the area serviced by the health maintenance organization, and, at the
option of the health maintenance organization, may provide additional coverage;

(3)     Except for any copayment or deductible arrangement, is compensated
only on a predetermined periodic rate basis for providing to members the minimum
services that are specified in item (2) of this subsection;

(4)     Assures its subscribers and members, the Commissioner, and the
Department that one clearly specified legal and administrative focal point or element of
the health maintenance organization has the responsibility of providing the availability,
accessibility, quality, and effective use of comprehensive health care services; and

(5)     Primarily provides services of physicians:

(i) Directly through physicians who are either employees or partners
of the health maintenance organization; or

(ii) Under arrangements with one or more groups of physicians, who
are organized on a group practice or individual practice basis, under which each group:

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