Ch. 605                                        1995 LAWS OF MARYLAND

may not on the average be less than 80 percent of the aggregate payments in that full
calendar year to preferred providers for similar services in the same geographic area
pursuant to the providers' agreements to provide the services under their provider service
agreements.

(4) FOR THE COMPREHENSIVE STANDARD HEALTH BENEFIT PLAN
ESTABLISHED UNDER THE PROVISIONS OF § 700 OF THIS ARTICLE, THE AGGREGATE
PAYMENTS IN ANY FULL CALENDAR YEAR MADE UNDER THIS PARAGRAPH TO
NONPREFERRED PROVIDERS AFTER ALL DEDUCTIBLE AND COPAYMENT
PROVISIONS HAVE BEEN APPLIED MAY NOT ON THE AVERAGE BE LESS THAN 75
PERCENT OF THE AGGREGATE PAYMENTS IN THAT FULL CALENDAR YEAR TO
PREFERRED PROVIDERS FOR SIMILAR SERVICES IN THE SAME GEOGRAPHIC AREA
IN ACCORDANCE WITH THE PROVIDERS' AGREEMENTS TO PROVIDE THE SERVICES
UNDER THEIR PROVIDER SERVICE AGREEMENTS.

Article—Health—General

19-710.

(R) (1) EXCEPT AS PROVIDED IN PARAGRAPH (3) OF THIS SUBSECTION, A
HEALTH MAINTENANCE ORGANIZATION IS SUBJECT TO THE PROVISIONS OF
ARTICLE 48A, § 657 OF THE CODE.

(3) - THE PROVISIONS OF SUBSECTION (O) OF THIS SECTION DO NOT
APPLY TO ANY CHARGES BY A PROVIDER NOT UNDER A WRITTEN CONTRACT WITH
A .HEALTH. MAINTENANCE ORGANIZATION FOR—PROFESSIONAL SERVICES
RENDERED UNDER THIS SUBSECTION WHO, PRIOR TO PROVIDING SERVICES,
DISCLOSES TO THE PATIENT:

(I) THAT THE PROVIDER IS NOT UNDER A WRITTEN CONTRACT
WITH THE PATIENT'S HEALTH MAINTENANCE ORGANIZATION; AND

(II) THE PROVIDER'S CHARGES FOR THE SERVICES.

(3) PARAGRAPH (1) OF THIS SUBSECTION DOES NOT APPLY TO SERVICES
PROVIDED SOLELY THROUGH EMPLOYEES OF THE HEALTH MAINTENANCE
ORGANIZATION.

Article 48A - Insurance Code

490BB..

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

(2) (I) "CARRIER" MEANS:

1. AN INSURER;

2. A NONPROFIT HEALTH SERVICE PLAN;

3. A HEALTH MAINTENANCE ORGANIZATION:

4. A DENTAL PLAN ORGANIZATION; OR

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