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Session Laws, 1999
Volume 796, Page 2014   View pdf image
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(B) THIS SECTION APPLIES TO;

(1) INSURERS AND NONPROFIT HEALTH SERVICE PLANS THAT PROVIDE
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS UNDER
HEALTH INSURANCE POLICIES THAT ARE ISSUED OR DELIVERED IN THE STATE; AND

(2) HEALTH MAINTENANCE ORGANIZATIONS THAT PROVIDE HOSPITAL,
MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS UNDER CONTRACTS
THAT ARE ISSUED OR DELIVERED IN THE STATE.

(C) (1) AN ENTITY SUBJECT TO THIS SECTION MAY NOT ESTABLISH OR
PROMOTE AN EMERGENCY MEDICAL RESPONSE AND TRANSPORTATION SYSTEM
THAT ENCOURAGES OR DIRECTS ACCESS BY AN INSURED OR ENROLLEE IN
COMPETITION WITH OR IN SUBSTITUTION OF THE MARYLAND EMERGENCY MEDICAL
SERVICES SYSTEM (911) OR OTHER STATE, COUNTY, OR LOCAL GOVERNMENT
EMERGENCY MEDICAL SERVICES SYSTEM.

(2) NOTWITHSTANDING PARAGRAPH (1) OF THIS SUBSECTION, AN
ENTITY MAY UTILIZE, FOR SERVICES THAT ARE NOT EMERGENCY SERVICES,
TRANSPORTATION OUTSIDE THE 911 OR OTHER GOVERNMENT EMERGENCY MEDICAL
SERVICES SYSTEMS.

(2) NOTWITHSTANDING PARAGRAPH (1) OF THIS SUBSECTION, AN
ENTITY SUBJECT TO THIS SECTION MAY USE TRANSPORTATION OUTSIDE THE 911
OR OTHER GOVERNMENT EMERGENCY MEDICAL SERVICES SYSTEM FOR SERVICES
THAT ARE NOT IN RESPONSE TO AN EMERGENCY MEDICAL CONDITION.

(D) AN ENTITY SUBJECT TO THIS SECTION MAY NOT REQUIRE AN INSURED OR
ENROLLEE TO OBTAIN PRIOR AUTHORIZATION BEFORE ACCESSING THE 911 SYSTEM
OR OTHER STATE, COUNTY, OR LOCAL GOVERNMENT EMERGENCY MEDICAL
SERVICES SYSTEM FOR AN EMERGENCY MEDICAL CONDITION.

(E) AN ENTITY SUBJECT TO THIS SECTION MAY NOT USE FALSE OR
MISLEADING LANGUAGE IN ITS ENROLLMENT SALES MATERIALS OR IN ANY OTHER
MATERIALS PROVIDED TO INSUREDS OR ENROLLEES TO DISCOURAGE OR PROHIBIT
INSUREDS OR ENROLLEES FROM ACCESSING THE 911 SYSTEM FOR EMERGENCY
AMBULANCE SERVICES IN THE EVENT OF
AN EMERGENCY MEDICAL CONDITION.

(F) AN ENTITY SUBJECT TO THIS SECTION SHALL REIMBURSE, LESS ANY
APPLICABLE CO PAYMENTS, THE APPROPRIATE PROVIDERS FOR ANY MEDICALLY
NECESSARY SERVICES PROVIDED TO AN INSURED OR ENROLLEE WHO ACCESSES
THE 911 SYSTEM OR OTHER STATE,
COUNTY, OR LOCAL GOVERNMENT EMERGENCY
SERVICES SYSTEM FOR AN EMERGENCY MEDICAL CONDITION.

Article - Health - General

19-706.

(FF) THE PROVISIONS OF § 15-126 OF THE INSURANCE ARTICLE APPLY TO
HEALTH MAINTENANCE ORGANIZATIONS.

 

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Session Laws, 1999
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