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Ch. 394
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2002 LAWS OF MARYLAND
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Article - Insurance
15-840.
(A) IN THIS SECTION, "RESIDENTIAL CRISIS SERVICES" MEANS INTENSIVE
MENTAL HEALTH AND SUPPORT SERVICES THAT ARE:
(1) PROVIDED TO A CHILD OR AN ADULT WITH A MENTAL ILLNESS WHO
IS EXPERIENCING OR IS AT RISK OF A PSYCHIATRIC CRISIS THAT WOULD IMPAIR THE
INDIVIDUAL'S ABILITY TO FUNCTION IN THE COMMUNITY;
(2) DESIGNED TO PREVENT A PSYCHIATRIC INPATIENT ADMISSION,
PROVIDE AN ALTERNATIVE TO PSYCHIATRIC INPATIENT ADMISSION, OR SHORTEN
THE LENGTH OF INPATIENT STAY; AND
(3) PROVIDED OUT OF THE INDIVIDUAL'S RESIDENCE ON A
SHORT-TERM BASIS IN A COMMUNITY-BASED RESIDENTIAL SETTING; AND
(4) PROVIDED BY ENTITIES THAT ARE LICENSED BY THE DEPARTMENT
OF HEALTH AND MENTAL HYGIENE TO PROVIDE RESIDENTIAL CRISIS SERVICES.
(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.
(C) (1) AN ENTITY SUBJECT TO THIS SECTION SHALL PROVIDE COVERAGE
FOR MEDICALLY NECESSARY RESIDENTIAL CRISIS SERVICES.
(2) THE SERVICES REQUIRED UNDER THIS SECTION MAY BE DELIVERED
UNDER A MANAGED CARE SYSTEM.
(C) AN ENTITY SUBJECT TO THIS SECTION SHALL PROVIDE COVERAGE FOR
RESIDENTIAL CRISIS SERVICES FOR AN INSURED OR AN ENROLLEE WITH A MENTAL
ILLNESS IF, IN THE JUDGMENT OF THE INSURED'S OR ENROLLEE'S TREATING
PHYSICIAN OR AN APPROPRIATELY LICENSED HEALTH CARE PROFESSIONAL, THE
RESIDENTIAL CRISIS SERVICES ARE MEDICALLY NECESSARY.
Article - Health - General
19-706.
(WW) THE PROVISIONS OF § 15-840 OF THE INSURANCE ARTICLE APPLY TO
HEALTH MAINTENANCE ORGANIZATIONS.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all
policies, contracts, and health benefit plans issued, delivered, or renewed in the State
on or after October 1, 2002.
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- 3058 -
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