Ch. 70

1997 LAWS OF MARYLAND

exercise of any right to acquire be in control of the foreign health maintenance
organization that is authorized to do business in this State; or

(2) That person may enter into an agreement to merge or consolidate with,
or otherwise to acquire control of, a foreign health maintenance organization that is
authorized to do business in this State.

(b) (1) Approval by the Insurance Commissioner shall be governed by [ Article
48A, § 494(e)] § 7-306 OF THE INSURANCE ARTICLE.

19-712.3.

(a) Except as provided in subsection (d) of this section, for services rendered to
its members or subscribers, a health maintenance organization shall accept as a properly
filed claim and the sole instrument for reimbursement the uniform claims form submitted
by a hospital or health care practitioner in accordance with [§ 490P of Article 48A of the
Code] § 15-1003 OF THE INSURANCE ARTICLE.

19-713.1.

(b) 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] § 15-109 OF THE INSURANCE ARTICLE, or
intensive care policy, which does not provide benefits on an expense incurred basis.

19-713.4.

(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] § 15-120 OF THE INSURANCE ARTICLE as the sole instrument for
referrals for consultation services.

19-714.

Each marketing document that sets forth the health care services of a health
maintenance organization shall describe fully and clearly:

(6) All information required by [Article 48A, § 703(c) of the Code] §
15-1206 OF THE INSURANCE ARTICLE.

19-716.

Annually, each health maintenance organization shall provide to its members and
make available to the general public, in clear, readable, and concise form:

(7) The information required to be disclosed by [Article 48A, § 703(c) of
the Code] § 15-1206 OF THE INSURANCE ARTICLE; and

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