PARRIS N. GLENDENING, Governor

S.B. 433

FOR the purpose of altering the definition of "point-of-service option" to specify that it
is a delivery system that permits a member or subscriber of a health maintenance
organization to receive services outside the health maintenance organization's
provider panel for any health care service that is covered under the member's or
subscriber's contract with the health maintenance organization.

BY repealing and reenacting, with amendments,
Article - Health - General
Section 19-710.2(a)
Annotated Code of Maryland
(1996 Replacement Volume and 1996 Supplement)

BY repealing and reenacting, without amendments,
Article - Health - General
Section 19-710.2(b)(l)
Annotated Code of Maryland
(1996 Replacement Volume and 1996 Supplement)

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

Article - Health - General

19-710.2.

(a) (1) In this section the following words have the meanings indicated.

(2)     "Carrier" means:
(i) An insurer;

(ii) A nonprofit health service plan;

(iii) A health maintenance organization;

(iv) A dental plan organization; or

(v) Any other person or organization that provides health benefit
plans subject to State regulation.

(3)     "Point-of-service option" means a delivery system HEALTH BENEFIT
PLAN that permits a member or subscriber of a health maintenance organization to
receive [ services] ANY HEALTH CARE SERVICE outside the provider panel of the
health maintenance organization THAT IS COVERED under the terms and conditions of
the member's or subscriber's contract with the health maintenance organization.

(4)     "Provider panel" means those providers with which a health
maintenance organization contracts to provide services to the health maintenance
organization's members or subscribers under the health maintenance organization's
health benefit plan.

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