H.B. 783                                                 VETOES

Preamble

WHEREAS, Over 10,000 Marylanders, over the age of 65, reside in continuing core
retirement communities; and

WHEREAS, Many older citizens choose to live in continuing care retirement
communities for the rest of their lives; and

WHEREAS; Continuing care retirement communities provide the entire continuum
of health-care services; and

WHEREAS, Continuing care retirement communities arc wellness managed care
organizations that have been in existence for over 20 years; and

WHEREAS, Health care services delivered in one's home are more cost effective
for the individual and the entire health-care system and are better for the physical,
mental, and overall well being of an individual; and

WHEREAS, Geographic separation for married individuals who reside together in
a continuing care retirement community would occur if they could not return to their
continuing care retirement community for rehabilitation and recuperation; now,
therefore,

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

Article - Health - General

19-712.6.

(A) WHENEVER A SUBSCRIBER OR AN ENROLLEE OF A HEALTH
MAINTENANCE ORGANIZATION IS A RESIDENT OF A CONTINUING CARE FACILITY
THAT IS REGULATED UNDER ARTICLE 70B OF THE CODE AND RECEIVED HEALTH
CARE SERVICES IN AN ACUTE CARE HEALTH CARE FACILITY, THE RESIDENT'S
PRIMARY CARE PHYSICIAN SHALL REFER IF MEDICALLY APPROPRIATE, THE
RESIDENT, IF MEDICALLY APPROPRIATE, TO THE RESIDENT'S CONTINUING CARE
FACILITY FOR THE PROVISION OF HEALTH CARE SERVICES, AS PROVIDED IN THE
RESIDENT'S CONTINUING CARE AGREEMENT SKILLED NURSING UNIT AT THE
RESIDENT'S CONTINUING CARE FACILITY FOR THE PROVISION OF THE HEALTH
CARE SERVICES INCLUDED IN THE RESIDENT'S HEALTH MAINTENANCE
ORGANIZATION MEDICARE CONTRACT. IF:

(1)     THE PRIMARY CARE PHYSICIAN AND THE RESIDENT OR THE
DESIGNATED REPRESENTATIVE OF THE RESIDENT DO NOT CHOOSE AN
ALTERNATIVE COURSE OF TREATMENT;

(2)     THE CONTINUING CARE FACILITY AGREES TO BE REIMBURSED AT
THE CONTRACT RATE NEGOTIATED BY THE HEALTH MAINTENANCE
ORGANIZATION WITH SIMILAR PROVIDERS FOR THE PROVISION OF THE SAME
HEALTH CARE SERVICES AND SUPPLIES; AND BECOMES A CONTRACTING PROVIDER
IN ACCORDANCE WITH THE HEALTH MAINTENANCE ORGANIZATION'S STANDARD

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