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PARRIS N. GLENDENING, Governor Ch. 569
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SUBSCRIBER UNDER A SUBROGATION PROVISION UNLESS THE SUBSCRIBER
RECOVERS FOR MEDICAL EXPENSES IN A CAUSE OF ACTION.
(E) A CONTRACT BETWEEN A HEALTH MAINTENANCE ORGANIZATION AND ITS
SUBSCRIBERS OR A CROUP OF SUBSCRIBERS MAY CONTAIN A PROVISION OR
PROVISIONS ALLOWING A HEALTH MAINTENANCE ORGANIZATION TO RECOVER ANY
PAYMENTS MADE TO THE SUBSCRIBER UNDER A PERSONAL INJURY PROTECTION
POLICY TO THE EXTENT THAT THE PAYMENTS ARE BASED ON SERVICES PROVIDED
OR PAID FOR BY THE HEALTH MAINTENANCE ORGANIZATION.
Article - Insurance
15-1205.
(d) (1) A carrier shall base its rating methods and practices on commonly
accepted actuarial assumptions and sound actuarial principles.
(2) A CARRIER THAT IS A HEALTH MAINTENANCE ORGANIZATION AND
THAT INCLUDES A SUBROGATION PROVISION IN ITS CONTRACT AS AUTHORIZED
UNDER § 19-713.1(D) OF THE HEALTH - GENERAL ARTICLE SHALL:
(I) USE IN ITS RATING METHODOLOGY AN ADJUSTMENT THAT
REFLECTS THE SUBROGATION; AND
(II) IDENTIFY IN ITS RATE FILING WITH THE ADMINISTRATION,
AND ANNUALLY IN A FORM APPROVED BY THE COMMISSIONER ALL AMOUNTS
RECOVERED THROUGH SUBROGATION.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to
any case pending or filed on or after the effective date of this Act, but may not be
applied to any case for which a final judgment has been rendered and for which
appeals have been exhausted prior to the effective date of this Act, or to any matter in
which a final written liability insurance settlement has been reached and payment
made between a liability insurer and a claimant.
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall apply to all
subrogation recoveries by health maintenance organizations recovered on or after
March 10, 1997 January 1, 1976.
SECTION 4. AND BE IT FURTHER ENACTED, That if any provision of this
Act or the application thereof to any person or circumstance is held invalid for any
reason in a court of competent jurisdiction, the invalidity does not affect other
provisions or any other application of this Act which can be given effect without the
invalid provision or application, and for this purpose the provisions of this Act are
declared severable.
SECTION 4. 5. AND BE IT FURTHER ENACTED, That this Act shall take
effect June 1, 2000.
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Approved May 18, 2000.
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- 3021 -
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