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H.B. 1068 VETOES
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BY repealing and reenacting, with amendments,
Article - Insurance
Section 15-112(j) 15-112(a) and (i)
Annotated Code of Maryland
(1997 Volume and 1999 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:
Article - Insurance
15-112.
(a) (1) In this section the following words have the meanings indicated.
(2) (i) "Carrier" means:
1. an insurer;
2. a nonprofit health service plan;
3. a health maintenance organization;
4. a dental plan organization; or
5. any other person that provides health benefit plans
subject to regulation by the State.
(ii) "Carrier" includes an entity that arranges a provider panel for a
carrier.
(3) "Enrollee" means a person entitled to health care benefits from a
carrier.
(4) "Provider" means a health care practitioner or group of health care
practitioners licensed, certified, or otherwise authorized by law to provide health care
services.
(5) (i) "Provider panel" means the providers that contract EITHER
DIRECTLY OR THROUGH A SUBCONTRACTING ENTITY with a carrier to provide health
care services to the carrier's enrollees under the carrier's health benefit plan.
(ii) "Provider panel" does not include an arrangement in which any
provider may participate solely by contracting with the carrier to provide health care
services at a discounted fee-for—service rate.
(j) [(1) A carrier shall provide to prospective enrollees before enrollment and
to existing enrollees at least once a year AN ENROLLEE AT THE TIME OF INITIAL
ENROLLMENT:
(i) a PRINTED list of providers on the carrier's provider panel; and
(ii) PRINTED information on providers that are no longer accepting
new patients.
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- 4716 -
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