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2000 LAWS OF MARYLAND
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Ch. 323
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(2) A HEALTH MAINTENANCE ORGANIZATION OR LICENSED HEALTH
SERVICES CONTRACTOR SHALL MEET THE REQUIREMENTS OF PARAGRAPH (1) OF
THIS SUBSECTION, REGARDLESS OF THE EXISTENCE OF THE SEGREGATED FUND OR
A CONTRARY PROVISION IN AN ADMINISTRATIVE SERVICE PROVIDER CONTRACT.
(3) NOTHING IN PARAGRAPH (1) OR PARAGRAPH (3) OF THIS SUBSECTION
MAY BE CONSTRUED TO PROHIBIT A HEALTH MAINTENANCE ORGANIZATION OR
LICENSED HEALTH SERVICES CONTRACTOR FROM SEEKING PAYMENT FROM THE
CONTRACTING PROVIDER OR FROM AMOUNTS HELD IN THE SEGREGATED FUND IN
ACCORDANCE WITH THIS SECTION FOR PAYMENTS MADE TO EXTERNAL PROVIDERS
ON BEHALF OF THE CONTRACTING PROVIDER.
(4) UPON THE FAILURE OF THE LICENSED HEALTH SERVICES
CONTRACTOR TO ACCEPT FINANCIAL AND ADMINISTRATIVE RESPONSIBILITY FOR
PAYMENT DUE TO EXTERNAL PROVIDERS ON BEHALF OF THE CONTRACTING
PROVIDER IN ACCORDANCE WITH PARAGRAPH (1) OF THIS SUBSECTION, THE
HEALTH MAINTENANCE ORGANIZATION THAT HAS ENTERED INTO A DOWNSTREAM
RISK CONTRACT WITH THE LICENSED HEALTH CARE PROVIDER SHALL:
(I) BE FINANCIALLY AND ADMINISTRATIVELY RESPONSIBLE FOR
PAYMENT DUE FROM THE CONTRACTING PROVIDER TO EXTERNAL PROVIDERS ON
BEHALF OF THE CONTRACTING PROVIDER; AND
(II) MAKE ALL PAYMENTS TO EXTERNAL PROVIDERS IN
ACCORDANCE WITH THE REQUIREMENTS OF § 15-1005 OF THIS TITLE.
(5) A HEALTH MAINTENANCE ORGANIZATION SHALL MEET THE
REQUIREMENTS OF PARAGRAPH (4) OF THIS SUBSECTION, REGARDLESS OF THE
EXISTENCE OF THE SEGREGATED FUND OR A CONTRARY PROVISION IN A
DOWNSTREAM RISK ASSUMPTION CONTRACT OR AN ADMINISTRATIVE SERVICE
PROVIDER CONTRACT.
(6) NOTHING IN PARAGRAPH (4) OR PARAGRAPH (5) OF THIS SUBSECTION
MAY BE CONSTRUED TO PROHIBIT A HEALTH MAINTENANCE ORGANIZATION FROM
SEEKING PAYMENT FROM THE CONTRACTING PROVIDER, THE LICENSED HEALTH
SERVICES CONTRACTOR, OR FROM AMOUNTS HELD IN THE SEGREGATED FUND IN
ACCORDANCE WITH THIS SUBTITLE FOR PAYMENTS MADE TO EXTERNAL PROVIDERS
ON BEHALF OF THE CONTRACTING PROVIDER.
(H) THE PLAN AND ALL SUPPORTING DOCUMENTATION SUBMITTED IN
CONNECTION WITH THE PLAN SHALL BE TREATED AS CONFIDENTIAL AND
PROPRIETARY, AND MAY NOT BE DISCLOSED EXCEPT AS OTHERWISE REQUIRED BY LAW.
15-10D-09.
(A) THE LICENSE OF A LICENSED HEALTH SERVICES PROVIDER EXPIRES ON
THE SECOND ANNIVERSARY OF ITS EFFECTIVE DATE UNLESS THE LICENSE IS
RENEWED FOR A 2 YEAR TERM AS PROVIDED IN THIS SECTION.
(B) BEFORE THE LICENSE EXPIRES, A LICENSE MAY BE RENEWED FOR AN
ADDITIONAL 2-YEAR TERM IF THE APPLICANT:
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- 1942 -
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