Ch. 712                                    1997 LAWS OF MARYLAND

Approved May 22, 1997.

CHAPTER 712

(House Bill 1057)

AN ACT concerning

Health Maintenance Organizations - Negotiated Alternative Rates - Coinsurance

Payments

FOR the purpose of providing that, if a health maintenance organization negotiates and
enters into a contract with certain health care providers to provide health care
services to its insureds at alternative rates of payment and coinsurance payments are
to be based on a percentage of the fee for health care services rendered by a
provider, the health maintenance organization shall calculate the amount of the
coinsurance payment to be paid by the insured from the negotiated alternative rate;
prohibiting health maintenance organizations from charging or collecting from an
insured a coinsurance payment amount that is greater than the coinsurance
payment amount calculated from the negotiated alternative rate; and generally
relating to requiring health maintenance organizations to calculate coinsurance
payment amounts from negotiated alternative rates under certain circumstances.

BY adding to

Article - Health - General

Section 19-706(n)

Annotated Code of Maryland

(1996 Replacement Volume and 1996 Supplement)

BY repealing and reenacting, without amendments,
Article - Insurance
Section 15-118
Annotated Code of Maryland
(1995 Volume and 1996 Supplement)
(As enacted by Chapter __ (H.B. 11) of the Acts of the General Assembly of 1997)

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

Article - Health - General

19-706.

(N) THE PROVISIONS OF § 15-118 OF THE INSURANCE ARTICLE SHALL APPLY
TO HEALTH MAINTENANCE ORGANIZATIONS.

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