Ch. 70

1997 LAWS OF MARYLAND

19-1305.4.

(e) (1) The private review agent or health maintenance organization may not
require additional documentation from, require additional utilization review of, or
otherwise provide financial disincentives for an attending provider who orders care for
which coverage is required to be provided under this section, § 19-703 of this article, or
[Article 48A, §§ 354F, 470H, or 477-I of the Code] § 15-811 OF THE INSURANCE
ARTICLE.

19-1306.

(d) The Secretary may delegate to the Commissioner the authority to renew a
certificate to any health insurer or nonprofit health service plan regulated under [Article
48A of the Code] THE INSURANCE ARTICLE or health maintenance organization issued
a certificate of authority in accordance with Subtitle 7 of this title that meets the
requirements of this subtitle and all applicable regulations of the Secretary.

19-1501.

(c) "Comprehensive standard health benefit plan" means the comprehensive
standard health benefit plan adopted in accordance with[ Article 48A, § 700 of the
Code] § 15-1207 OF THE INSURANCE ARTICLE.

(h) "Payor" means:

(1) A health insurer or nonprofit health service plan that holds a certificate
of authority and provides health insurance policies or contracts in the State in accordance
with this article or [Article 48A of the Code] THE INSURANCE ARTICLE;

(2) A health maintenance organization that holds a certificate of authority
in the State; or

(3) A third party administrator as defined in [Article 48A, § 490R of the
Code] § 15-111 OF THE INSURANCE ARTICLE.

19-1502.

(c) The purpose of the Commission is to:

(5) Develop a uniform set of effective benefits to be included in the
comprehensive standard health benefit plan to apply under [Subtitle 55 of Article 48A of
the Code] TITLE 15, SUBTITLE 12 OF THE INSURANCE ARTICLE;

19-1507.

(i) The Commission, in consultation with the Insurance Commissioner, payors,
health care practitioners, and hospitals, may adopt by regulation standards for the
electronic submission of data and submission and transfer of the uniform claims forms
established under [Article 48A, § 490P of the Code] § 15-1003 OF THE INSURANCE
ARTICLE.

19-1509.

(a) (3) "Payor" means:

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