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Ch. 382
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2002 LAWS OP MARYLAND
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certain determinations are considered adverse decisions; prohibiting certain
insurance carriers from requiring certain children to seek or receive habilitative
services in a certain manner; defining a certain term; altering a certain
definition; providing for the application of this Act; and generally relating to
habilitative services for children.
BY repealing and reenacting, with amendments,
Article - Insurance
Section 15-835
Annotated Code of Maryland
(1997 Volume and 2001 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) (I) "CONGENITAL OR GENETIC BIRTH DEFECT" MEANS A DEFECT
EXISTING AT OR FROM BIRTH, INCLUDING A HEREDITARY DEFECT.
(II) "CONGENITAL OR GENETIC BIRTH DEFECT" INCLUDES, BUT IS
NOT LIMITED TO:
1. AUTISM OR AN AUTISM SPECTRUM DISORDER; AND
2. CEREBRAL PALSY; OR.
3. A CONDITION OR DISEASE RELATED TO PREMATURE
BIRTH.
[(2)] (3) "Habilitative services" means services, including occupational
therapy, physical therapy, and speech therapy, for the treatment of a child with A
congenital [and] OR genetic birth [defects] DEFECT to enhance the child's ability to
function.
[(3)] (4) "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.
(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
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