|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Ch. 92 2000 LAWS OF MARYLAND
|
|
|
|
|
|
|
|
|
Commission to submit a certain report to the House Economic Matters
Committee and the Senate Finance Committee on or before a certain date;
providing for the application of this Act; and generally relating to coverage for
rehabilitation of habilitative services for children by health insurers, nonprofit
health service plans, and health maintenance organizations.
BY adding to
Article - Insurance
Section 15-835
Annotated Code of Maryland
(1997 Volume and 1999 Supplement)
BY adding to
Article - Health - General
Section 19-706(nn)
Annotated Code of Maryland
(1996 Replacement 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
15-835.
(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.
(2) "HABILITATIVE SERVICES" MEANS SERVICES, INCLUDING
OCCUPATIONAL THERAPY, PHYSICAL THERAPY, AND SPEECH THERAPY, FOR THE
TREATMENT OF A CHILD WITH CONGENITAL AND GENETIC BIRTH DEFECTS TO
ENHANCE THE CHILD'S ABILITY TO FUNCTION.
(3) "MANAGED CARE SYSTEM" MEANS A METHOD THAT AN INSURER, A
NONPROFIT HEALTH SERVICE PLAN, OR A HEALTH MAINTENANCE ORGANIZATION
USES TO REVIEW AND PREAUTHORIZE A TREATMENT PLAN THAT A HEALTH CARE
PRACTITIONER DEVELOPS FOR A COVERED PERSON USING A VARIETY OF COST
CONTAINMENT METHODS TO CONTROL UTILIZATION, QUALITY, AND CLAIMS.
(A) (B) THIS SECTION APPLIES TO:
(1) INSURERS AND NONPROFIT HEALTH SERVICE PLANS THAT PROVIDE
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS ON AN
EXPENSE-INCURRED BASIS UNDER HEALTH INSURANCE POLICIES OR CONTRACTS
THAT ARE ISSUED OR DELIVERED IN THE STATE; AND
(2) HEALTH MAINTENANCE ORGANIZATIONS THAT PROVIDE HOSPITAL,
MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS UNDER CONTRACTS
THAT ARE ISSUED OR DELIVERED IN THE STATE.
|
|
|
|
|
|
|
|
|
|
- 686 -
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
 |
