§ 19-712. Powers and duties of health maintenance organization
West's Annotated Code of MarylandHealth--General
MD Code, Health - General, § 19-712
§ 19-712. Powers and duties of health maintenance organization
(a) Subject to the provisions of subsection (b) of this section, a person who holds a certificate of authority to operate a health maintenance organization under this subtitle may:
(b)(1) A person who holds a certificate of authority to operate a health maintenance organization under this subtitle and who enters into any administrative service provider contract, as defined in § 19-713.2 of this subtitle, with a person or entity for the provision of health care services to subscribers shall be responsible for all claims or payments for health care services:
(ii) Rendered by a provider, who is not the person or entity which entered into the administrative service provider contract with the health maintenance organization, pursuant to a referral by a person or entity which entered into the administrative service provider contract with the health maintenance organization.
(c) The responsibility of a health maintenance organization for claims or payments for health care services in accordance with subsection (b) of this section under an administrative service provider contract:
(d) Subsections (b) and (c) of this section apply to a contract between a health maintenance organization and any company affiliated with the health maintenance organization through common ownership within an insurance holding company system, that meets the definition of a contracting provider under § 19-713.2 of this subtitle.
Credits
Added by Acts 1982, c. 21, § 2, eff. July 1, 1982. Amended by Acts 1991, c. 446, §§ 1, 2, eff. July 1, 1991; Acts 2000, c. 61, § 1, eff. April 25, 2000; Acts 2000, c. 323, § 2, eff. June 1, 2000.
Formerly Art. 43, § 845.
MD Code, Health - General, § 19-712, MD HEALTH GEN § 19-712
Current through legislation effective through April 25, 2024, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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