Ch. 363 1997 LAWS OF MARYLAND

(2) ENABLE PROVIDERS TO DETERMINE, WITH ONE TELEPHONE CALL
THE CURRENT ROSTER OF CONTRACTED SPECIALIST PROVIDERS FOR THE HEALTH MAINTENANCE
ORGANIZATION;

(3) PROVIDE AUTHORIZATION OR ASSIGN A PRIMARY CARE PROVIDER
AT THE INITIAL TELEPHONE ACCESS FOR MEMBERS WHO DO NOT HAVE AN
ASSIGNED PRIMARY CARE PROVIDER; AND

(4) COMMUNICATE ANY LIMITATIONS PLACED ON WHICH PROVIDER
MAY BE UTILIZED.

(B) (1) EACH HEALTH MAINTENANCE ORGANIZATION SHALL PROVIDE A
CURRENT ROSTER OF PRIMARY CARE AND SPECIALIST PROSPERS TO EACH
HOSPITAL IN THE STATE.

(2) EACH HEALTH MAINTENANCE ORGANIZATION SHALL UPDATE THE
ROSTER ON A QUARTERLY BASIS:

(3) A HEALTH MAINTENANCE ORGANIZATION MAY SEND THE ROSTER
TO EACH HOSPITAL BY COMPATIBLE COMPUTER DISKETTE.

(C) (A) IF IT IS NECESSARY TO PROVIDE EMERGENCY SERVICES,
AUTHORIZATION SHALL BE PRESUMED FOR UTILIZING THE MEDICAL OR SURGICAL
PROVIDER ON CALL FOR UNASSIGNED PATIENTS OR THE APPROPRIATE SPECIALIST
ON CALL FOR THE HOSPITAL ON THAT DATE IF:

(1) A TELEPHONE ACCESS SYSTEM IS NOT OPERATIONAL AT THE TIME
OF THE CALL; OR

(2) A MEMBER'S PRIMARY CARE PROVIDER OR THE SPECIALIST
NEEDED BY A MEMBER CANNOT BE DETERMINED WITHIN A REASONABLE TIME, AS
DETERMINED BY THE TREATING EMERGENCY PHYSICIAN BUT NOT TO EXCEED 30
MINUTES AFTER THE INITIAL DOCUMENTED CALL TO THE TELEPHONE ACCESS
SYSTEM.

(B) THIS SECTION MAY NOT BE CONSTRUED TO REQUIRE A HEALTH
MAINTENANCE ORGANIZATION TO HAVE CONTRACTED SPECIALIST PROVIDERS AT
HOSPITALS OUTSIDE OP THE SERVICE AREA OF THE HEALTH MAINTENANCE
ORGANIZATION

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

Article - Health - General

19-705. 7.

THE 24-HOUR TOLL FREE TELEPHONE ACCESS SYSTEM PROVIDED BY EACH
HEALTH MAINTENANCE ORGANIZATION SHALL:

(1) ENABLE MEMBERS AND PROVIDERS TO DETERMINE, WITH ONE
TELEPHONE CALL THE PRIMARY CARE PROVIDER ASSIGNED TO A MEMBER; AND

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