Ch. 577                                  1995 LAWS OF MARYLAND

NONDUPLICATION OR COORDINATION OF COVERAGE WITH SUBSCRIBER
CONTRACTS OF OTHER HEALTH MAINTENANCE ORGANIZATIONS, HEALTH
INSURANCE POLICIES, AND OTHER ESTABLISHED PROGRAMS UNDER WHICH THE
SUBSCRIBER OR MEMBER MAY MAKE A CLAIM.

(2) A HEALTH MAINTENANCE ORGANIZATION MAY NOT IMPOSE AS A
CONDITION OF COVERAGE ANY REQUIREMENT TO;

(I) MODIFY THE UNIFORM COORDINATION OF BENEFITS FORM;
OR

(II) SUBMIT ADDITIONAL COORDINATION OF BENEFITS FORMS.

[(b)](C) Notwithstanding the provisions of subsection (a) of this section, a
contract between a health maintenance organization and its subscribers or a group of
subscribers may not contain nonduplication provisions or provisions to coordinate
coverage with any individually underwritten and issued, guaranteed renewable, specified
disease policy, as defined in Article 48A, § 468H of the Code, or intensive care policy,
which does not provide benefits on an expense incurred basis.

[(c)](D) For purposes of this section, "intensive care policy" means a health
insurance policy that provides benefits only when treatment is received in that specifically
designated facility of a hospital that provides the highest level of care and which is
restricted to those patients who are physically, critically ill or injured.

19-713.1.

(A) (1) IF A HEALTH MAINTENANCE ORGANIZATION REQUIRES ITS
SUBSCRIBERS TO HAVE A REFERRAL TO RECEIVE LABORATORY SERVICES IN
WRITING, THE HEALTH MAINTENANCE ORGANIZATION SHALL USE THE UNIFORM
LABORATORY REFERRAL FORM ADOPTED BY THE COMMISSIONER UNDER ARTICLE
48A, § 490BB OF THE CODE AS THE SOLE INSTRUMENT FOR REFERRALS FOR
LABORATORY SERVICES.

(2) A HEALTH MAINTENANCE ORGANIZATION MAY NOT IMPOSE AS A
CONDITION OF COVERAGE ANY REQUIREMENT TO;

(I) MODIFY THE UNIFORM LABORATORY REFERRAL FORM; OR

(II) SUBMIT ADDITIONAL LABORATORY REFERRAL FORMS.

(3) THE UNIFORM LABORATORY REFERRAL FORM SHALL BE
PROPERLY COMPLETED BY THE HEALTH CARE PROVIDER REFERRING THE
SUBSCRIBER FOR LABORATORY SERVICES.

19-713.4.

(B) (1) (A) IF A HEALTH MAINTENANCE ORGANIZATION REQUIRES ITS
SUBSCRIBERS TO HAVE A REFERRAL TO RECEIVE CONSULTATION SERVICES IN
WRITING, THE HEALTH MAINTENANCE ORGANIZATION SHALL USE THE UNIFORM
CONSULTATION REFERRAL FORM ADOPTED BY THE COMMISSIONER UNDER
ARTICLE 48A, § 490BB OF THE CODE AS THE SOLE INSTRUMENT FOR REFERRALS FOR
CONSULTATION SERVICES.

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