PARRIS N. GLENDENING, Governor                             Ch. 352

(15)   Develop joint legislative and executive branch strategies to persuade the
federal government to reconsider those policies that discourage the delivery of cost
effective health care SERVICES to Program recipients;

(16)   Evaluate departmental recommendations as to those persons whose
financial need or health care needs are most acute;

(17)   Establish mechanisms for aggressively pursuing recoveries against third
parties permitted under current law and exploring additional methods for seeking to
recover other moneys expended by the Program; and

(18)   Take appropriate measures to assure the quality of health care
SERVICES provided by managed care [plans] ORGANIZATIONS.

15-102.2

(A) EXCEPT AS OTHERWISE PROVIDED IN THIS SECTION. THE PROVISIONS OF §
19-706.1 OF THIS ARTICLE (REHABILITATION AND LIQUIDATION) SHALL APPLY TO
MANAGED CARE ORGANIZATIONS IN THE SAME MANNER THEY APPLY TO HEALTH
MAINTENANCE ORGANIZATIONS.

(B) (1) A HEALTH CARE PROVIDER MAY NOT ASSERT A CLAIM OF
SUBROGATION AGAINST AN ENROLLEE OF A MANAGED CARE ORGANIZATION OR THE
STATE

(2) NOTWITHSTANDING PARAGRAPH (I) OF THIS SUBSECTION A HEALTH
CARE PROVIDER MAY ASSERT ANY CLAIM IT MAY HAVE AGAINST THE RECEIVER OF THE
INSOLVENT MANAGED CARE ORGANIZATION.

I5-102.3.

(A) THE PROVISIONS OF ARTICLE 48A, § 490CC OF THE CODE (PROVIDER
PARTICIPATION STANDARDS) SHALL APPLY TO MANAGED CARE ORGANIZATIONS IN THE
SAME MANNER THEY APPLY TO CARRIERS.

(B) THE PROVISIONS OF § 19-712.1 OF THIS ARTICLE (PROMPT PAYMENT) SHALL
APPLY TO MANAGED CARE ORGANIZATIONS IN THE SAME MANNER THEY APPLY TO
HEALTH MAINTENANCE ORGANIZATIONS.

(C) (1) EXCEPT AS OTHERWISE PROVIDED IN THIS SUBSECTION THE
PROVISIONS OF § 19-718 OF THIS ARTICLE (FINANCIAL AFFAIRS EXAMINATION) SHALL
APPLY TO MANAGED CARE ORGANIZATIONS IN THE SAME MANNER THEY APPLY TO
HEALTH MAINTENANCE ORGANIZATIONS.

(2) THE INSURANCE COMMISSIONER OR AN AGENT OF THE COMMISSIONER
SHALL EXAMINE THE FINANCIAL AFFAIRS AND STATUS OF EACH MANAGED CARE
ORGANIZATION AT LEAST ONCE EVERY 5 YEARS.

15-102.4.

(A) (1) EACH MANAGED CARE ORGANIZATION SHALL BE ACTUARIALLY
SOUND.

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