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Session Laws, 2000
Volume 797, Page 2998   View pdf image
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Ch. 565 2000 LAWS OF MARYLAND
(18) TWO PREVENTIVE DENTAL EXAMS PER YEAR; AND
(19) EMERGENCY MEDICAL OUTPATIENT TREATMENT. 15-604. THE MANAGED CARE PROVIDER MAY: (1) REQUIRE A DEDUCTIBLE TO APPLY TO PRESCRIPTION BENEFITS AND
CO-PAYMENTS THAT ARE EQUAL OR LESS THAN THOSE REQUIRED BY THE
MEDICARE PART "B" BENEFITS PROVIDED UNDER TITLE XVIII OF THE SOCIAL
SECURITY ACT, AS AMENDED; (2) ESTABLISH A RESTRICTED FORMULARY OF EXPERIMENTAL DRUGS
THAT WILL NOT BE REIMBURSED BY THE PROGRAM; AND (3) ESTABLISH A CO-PAYMENT SYSTEM FOR PRESCRIPTION DRUGS
BASED ON THE USE OF BRAND OR GENERIC DRUGS. 15-605. THE SECRETARY SHALL: (1) PAY A MANAGED CARE PROVIDER WITHIN 30 DAYS AFTER RECEIPT
OF A CLAIM FOR PAYMENT OF SUBSIDIES; (2) SUBMIT A REPORT TO THE GENERAL ASSEMBLY ON OR BEFORE JUNE
30, 2001, AND IN EACH SUCCESSIVE YEAR, THAT INCLUDES A SUMMARY OF THE
PROGRAM ACTIVITIES FOR THE YEAR AND ANY RECOMMENDATIONS OR
SUGGESTIONS FOR LEGISLATIVE CONSIDERATION; AND (3) ADOPT REGULATIONS TO CARRY OUT THE PROVISIONS OF THIS SECTION. (A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED. (B) "CARRIER" MEANS: (1) AN AUTHORIZED INSURER; (2) A NONPROFIT HEALTH SERVICE PLAN; (3) A HEALTH MAINTENANCE ORGANIZATION; (4) A MANAGED CARE ORGANIZATION; (5) A DENTAL PLAN ORGANIZATION; OR (6) ANY OTHER PERSON THAT PROVIDES HEALTH BENEFIT PLANS
SUBJECT TO REGULATION BY THE STATE. (C) "ELIGIBLE INDIVIDUAL" MEANS AN INDIVIDUAL WHO: (1) IS A RESIDENT OF MARYLAND AND AT LEAST 65 YEARS OF AGE;
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Session Laws, 2000
Volume 797, Page 2998   View pdf image
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