PARRIS N. GLENDENING, Governor                             Ch. 503

Annotated Code of Maryland

(1990 Replacement Volume and 1995 Supplement)

BY repealing

Article - Health - General

Section 19-710(q)

Annotated Code of Maryland

(1990 Replacement Volume and 1995 Supplement)

BY adding to

Article - Health - General

Section 19-712.5

Annotated Code of Maryland

(1990 Replacement Volume and 1995 Supplement)

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

Article - Health - General

19-705.1.

(b) The standards of quality of care shall include:

(1)     (i) A requirement that a health maintenance organization shall
provide for regular hours during which a member may receive services, including
providing for services to a member in a timely manner that takes into account the
immediacy of need for services; and

(ii) Provisions for assuring that all covered services, including any
services for which the health maintenance organization has contracted, are accessible to
the enrollee with reasonable safeguards with respect to geographic locations.

(2)     [(i)] A requirement that a health maintenance organization shall have a
system for providing a member with 24-hour access to a physician in cases where there is
an immediate need for medical services, including providing 24-hour access by telephone
to a person who is able to appropriately respond to calls from members and providers
concerning after-hours care;

[(ii) To meet this requirement for off-hour services, the health
maintenance organization may provide for access to a physician who does not have a
contract with the health maintenance organization or a facility, such as a hospital
emergency room; and

(iii) If a physician who does not have a contract with a health
maintenance organization is used or a facility that is not connected with a health
maintenance organization is used, the health maintenance organization shall:

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