Annually, each health maintenance organization shall provide to its members and make available to the general public, in clear, readable, and concise form:
(1) A summary of the most recent financial report that the health maintenance organization submits to the Commissioner under § 19-717 of this subtitle;
(2) A description of the benefit packages available and the nongroup rates required by the Commissioner;
(3) A description of the accessibility and availability of services, including where and how to obtain them;
(4) A statement of the potential responsibility of a member for payment for services the member seeks to obtain from a provider, including a physician or hospital, that does not have a written contract with the health maintenance organization;
(5) A description of procedures to be followed for emergency services, including:
(i) The appropriate use of hospital emergency facilities;
(ii) The appropriate use, location, and hours of operation of any urgent care facilities operated by the health maintenance organization; and
(iii) The potential responsibility of subscribers and enrollees for payment for emergency services or nonemergency services rendered in a hospital emergency facility;
(6) A statement that shows, by category, the percentage of members assisted by public funds;
(7) The information required to be disclosed by § 15-1206 of the Insurance Article; and
(8) Any other information that the Commissioner or the Department requires by rule or regulation.
Credits
Added by Acts 1982, c. 21, § 2, eff. July 1, 1982. Amended by Acts 1993, c. 9, § 2, eff. July 1, 1994; Acts 1996, c. 503, § 3, eff. July 1, 1996; Acts 1997, c. 70, § 4, eff. Oct. 1, 1997.
Formerly Art. 43, § 855.
MD Code, Health - General, § 19-716, MD HEALTH GEN § 19-716
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.
