PARRIS N. GLENDENING, Governor

Ch. 605

(B) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION, AS A
CONDITION OF LICENSURE, CERTIFICATION, OR OTHER AUTHORIZATION UNDER
THE HEALTH OCCUPATIONS ARTICLE TO PROVIDE HEALTH CARE SERVICES, A
PRACTITIONER SHALL AGREE TO PARTICIPATE IN THE MARYLAND MEDICAL
ASSISTANCE PROGRAM IF THE PROGRAM PROVIDES COVERAGE FOR THE SERVICES
OF THE PRACTITIONER.

(2) THE REQUIREMENT OF PARAGRAPH (1) OF THIS SUBSECTION DOES
NOT APPLY TO A PRACTITIONER UNDER AN EXCLUSIVE CONTRACT WITH A HEALTH
MAINTENANCE ORGANIZATION.

(C) A PRACTITIONER WHO VIOLATES THIS SECTION IS SUBJECT TO
DISCIPLINARY ACTION BY THE AGENCY THAT CERTIFIES, LICENSES, OR OTHERWISE
AUTHORIZES THE PRACTITIONER TO PROVIDE HEALTH CARE SERVICES.

Article - Health - General

19-706.

(i) The provisions of Article 48A, [§ 490U] §§ 490U, 490BB. AND 490CC of the
Code shall apply to health maintenance organizations..

19-710.2.

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

(2) "CARRIER" MEANS:

(I)      AN INSURER;

(II)     A NONPROFIT HEALTH SERVICE PLAN;

(III)   A HEALTH MAINTENANCE ORGANIZATION;

(IV)    A DENTAL PLAN ORGANIZATION; OR

(V)     ANY OTHER PERSON OR ORGANIZATION THAT PROVIDES
HEALTH BENEFIT PLANS SUBJECT TO STATE REGULATION.

(3) "POINT-OF-SERVICE OPTION" MEANS A DELIVERY SYSTEM THAT
PERMITS A MEMBER OR SUBSCRIBER OF A HEALTH MAINTENANCE ORGANIZATION
TO RECEIVE HEALTH CARE SERVICES OUTSIDE THE PROVIDER PANEL OF THE
HEALTH MAINTENANCE ORGANIZATION UNDER THE TERMS AND CONDITIONS OF THE
MEMBER'S OR SUBSCRIBER'S CONTRACT WITH THE HEALTH MAINTENANCE
ORGANIZATION.

(4) "PROVIDER PANEL" MEANS THOSE PROVIDERS WITH WHICH A
HEALTH MAINTENANCE ORGANIZATION CONTRACTS TO PROVIDE HEALTH CARE
SERVICES TO THE HEALTH MAINTENANCE ORGANIZATION'S MEMBERS OR
SUBSCRIBERS UNDER THE HEALTH MAINTENANCE ORGANIZATION'S HEALTH
BENEFIT PLAN.

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