PARRIS N. GLENDENING, Governor

Ch. 245

(II) THEIR IMPACT ON MAINTAINING AND IMPROVING HEALTH
AND ENCOURAGING CONSUMERS TO USE ONLY THE HEALTH CARE SERVICES THEY
NEED; AND

(III) THEIR IMPACT ON THE AFFORD ABILITY OF HEALTH CARE

COVERAGE

(3) THE HEALTH CARE ACCESS AND COST COMMISSION MAY EXCLUDE
FROM THE PLAN:

(I) A HEALTH CARE SERVICE, BENEFIT, COVERAGE, OR
REIMBURSEMENT FOR COVERED HEALTH CARE SERVICES THAT IS REQUIRED
UNDER THIS ARTICLE OR THE HEALTH - GENERAL ARTICLE TO BE PROVIDED OR
OFFERED IN A HEALTH BENEFIT PLAN THAT IS ISSUED OR DELIVERED IN THE STATE
BY A CARRIER; OR

(II) REIMBURSEMENT REQUIRED BY STATUTE, BY A HEALTH
BENEFIT PLAN FOR A SERVICE WHEN THAT SERVICE IS PERFORMED BY A HEALTH
CARE PROVIDER WHO IS LICENSED UNDER THE HEALTH OCCUPATIONS ARTICLE
AND WHOSE SCOPE OF PRACTICE INCLUDES THAT SERVICE.

(4) THE PLAN SHALL INCLUDE UNIFORM DEDUCTIBLES AND
COST-SHARING ASSOCIATED WITH ITS BENEFITS, AS DETERMINED BY THE HEALTH
CARE ACCESS AND COST COMMISSION.

(5) IN ESTABLISHING COST-SHARING AS PART OF THE PLAN, THE
HEALTH CARE ACCESS AND COST COMMISSION SHALL:

(I) INCLUDE COST-SHARING AND OTHER INCENTIVES TO HELP
CONSUMERS USE ONLY THE SERVICES THEY NEED;

(II) BALANCE THE EFFECT OF COST-SHARING IN REDUCING
PREMIUMS AND IN AFFECTING UTILIZATION OF APPROPRIATE SERVICES; AND

(HI) LIMIT THE TOTAL COST-SHARING THAT MAY BE INCURRED BY
AN INDIVIDUAL IN A YEAR.

Article - Health - General

19-1502.

(c) The purpose of the Commission is to:

(10) Foster the development of practice parameters; [and]

(11) Reduce the costs of claims submission and the administration of claims
for health care practitioners and payors; AND

(12) DEVELOP A UNIFORM SET OF EFFECTIVE BENEFITS TO BE OFFERED
AS SUBSTANTIAL, AVAILABLE, AND AFFORDABLE COVERAGE IN THE NONGROUP
MARKET IN ACCORDANCE WITH ARTICLE 48A, § 490S(A-1) OF THE CODE.

SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland
read as follows:

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