Approved May 27, 1999.

CHAPTER 644
(House Bill 576)

AN ACT concerning

Continuity of Patient Care Act

FOR the purpose of requiring a health maintenance organization that allows a
member or subscriber to receive certain emergency medical services, under
certain circumstances, reimburse a physician in an urgent care facility
certain health care provider who provides certain medically necessary follow-up
care to a member or subscriber of the health maintenance organization;
prohibiting a health maintenance organization, under certain circumstances,
from imposing on a member or subscriber any co-payment or other cost-sharing
requirement that exceeds what the member or subscriber is required to pay for
services rendered by a physician health care provider who is a member of the
provider panel of the health maintenance organization; and generally relating to
health maintenance organizations.

BY adding to

Article - Health - General
Section 19-712.7 19-712.5(f)
Annotated Code of Maryland

(1996 Replacement Volume and 1998 Supplement)

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

Article - Health - General

10-712.7.

IF A HEALTH MAINTENANCE ORGANIZATION AUTHORIZES, DIRECTS, REFERS,
OR OTHERWISE ALLOWS A MEMBER OR SUBSCRIBER OF THE HEALTH MAINTENANCE
ORGANIZATION TO USE A MEDICAL FACILITY THAT PROVIDES IMMEDIATE URGENT
CARE SERVICES FOR A CONDITION THAT READILY NECESSITATES A SURGICAL
PROCEDURE, THE HEALTH MAINTENANCE ORGANIZATION:

(1) SHALL REIMBURSE A PHYSICIAN IN THE URGENT CARE FACILITY
FOR PROVIDING ANY MEDICALLY NECESSARY FOLLOW UP CARE RELATED TO THE
CONDITION FOR WHICH THE SURGICAL PROCEDURE WAS PERFORMED; AND

(2) MAY NOT IMPOSE ON THE MEMBER OR SUBSCRIBER ANY
CO PAYMENT OR OTHER COST SHARING REQUIREMENT THAT EXCEEDS WHAT THE