CHAPTER 697
(House Bill 1210)

AN ACT concerning

Department of Health and Mental Hygiene - Health Maintenance
Organization (HMO) Quality Assurance Unit - Quality Assurance Medical

Director

FOR the purpose of establishing a Health Maintenance Organization (HMO) Quality.
Assurance Unit in the Department of Health and Mental Hygiene; requiring
that the Secretary appoint a Quality Assurance Medical Director for the Unit;
requiring that the Quality Assurance Medical Director be a physician who is
licensed in the State and establishing certain other qualifications for the
Quality Assurance Medical Director; establishing a term of office for the Quality
Assurance Medical Director; authorizing the Secretary to remove the Quality
Assurance Medical Director under certain circumstances; requiring the HMO
Quality Assurance Unit to investigate quality of care complaints referred from
the Insurance Commissioner and enforce certain other statutory and regulatory
requirements relating to the quality of health care provided by health
maintenance organizations; requiring the Quality Assurance Medical Director to
determine whether a health maintenance organization meets certain statutory
and regulatory requirements relating to the quality of health care provided by a
health maintenance organization and make recommendations for corrective
changes or new arrangements action necessary to meet these requirements;
authorizing the Secretary to take certain action under certain circumstances;
authorizing the Insurance Commissioner to suspend, revoke, or refuse to renew
the certificate of the medical director of a health maintenance organization
under certain circumstances; repealing the authority of the Secretary to send a
written directive to the Insurance Commissioner directing the Insurance
Commissioner to take certain actions; authorizing the Insurance Commissioner
to impose certain penalties on a health maintenance organization under certain
circumstances; requiring the Insurance Commissioner to give certain notice to
the Secretary under certain circumstances; repealing provisions that require the
Insurance Commissioner to give certain notice to a health maintenance
organization and hold a hearing before taking certain actions; authorizing the
Secretary to issue certain orders and impose certain penalties under certain
circumstances; requiring the Secretary to give certain notice to the Insurance
Commissioner under certain circumstances; providing that an aggrieved party is
entitled to certain rights of appeal if the Secretary takes certain action; making
certain appeal provisions inapplicable to a certain order issued by the Insurance
Commissioner at the request of the Secretary; defining certain terms; making
certain conforming changes; and generally relating to the Department of Health
and Mental Hygiene and health maintenance organizations.

BY repealing and reenacting, without amendments,
Article - Health - General
Section 19-702(b)(3), 19-705.2, and 19-729