|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PARRIS N. GLENDENING, Governor
|
|
|
|
|
|
Ch. 320
|
|
|
|
|
|
|
|
|
|
|
|
|
|
[purchaser] differential under § 19-207.1(C) OF THE HEALTH - GENERAL ARTICLE
AND regulations adopted by the COMMISSIONER AND THE [Health Services Cost
Review] Commission.
[(2)](B) In establishing a plan under this [subsection] SECTION, the
Maryland—Health—Care—Commission shall judge preventive services, medical
treatments, procedures, and related health services based on:
[(i)] (1) their effectiveness in improving the health of individuals;
[(ii)](2) their impact on maintaining and improving health and
encouraging consumers to use only the health care services they need; and
[(iii)(3) their impact on the affordability of health care coverage.
[(3)] (C) The Maryland Health Care Commission may exclude from the
plan:
[(i)] (1) a health care service, benefit, coverage, or reimbursement
for covered health care services that is required under this article or the Health—
General Article to be provided or offered in a health benefit plan that is issued or
delivered in the State by a carrier; or
[(ii)] (2) reimbursement required by statute, by a health benefit
plan for a service when that service is performed by a health care provider who is
licensed under the Health Occupations Article and whose scope of practice includes
that service.
[(4)] (D) The plan shall include uniform deductibles and cost sharing
associated with its benefited as determined by the Maryland Health Care
Commission.
[(5)] (E) In establishing cost-sharing as part of the plan, the Maryland
Health Care Commission shall:
[(i)] (1) include cost sharing and other incentives to help
consumers use only the health-care services they need;
[(ii)] (2) balance the effect of cost sharing in reducing premiums
and in affecting utilization of appropriate services; and
[(iii)](3) limit the total cost sharing that may be incurred by an
individual in a year.
15-6A-05.
THE COMMISSIONER MAY ADOPT REGULATIONS TO IMPLEMENT THIS
SUBTITLE.
SECTION 2. AND BE IT FURTHER ENACTED, That, until January 1, 2002,
the Health Services Cost Review Commission may not take any action to eliminate or
adjust the SAAC differential that is in effect on June April 1, 2000 until:
|
|
|
|
|
|
|
|
|
|
- 1915 -
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
 |
