Md. Code Ann., Health-Gen. § 19-716

Duty to Provide Information to Members, General Public

Effective Oct 1, 1997Added 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.State of Maryland

Annually, each health maintenance organization shall provide to its members and make available to the general public, in clear, readable, and concise form:

  1. (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. (2) A description of the benefit packages available and the nongroup rates required by the Commissioner;
  3. (3) A description of the accessibility and availability of services, including where and how to obtain them;
  4. (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. (5) A description of procedures to be followed for emergency services, including:

    1. (i) The appropriate use of hospital emergency facilities;
    2. (ii) The appropriate use, location, and hours of operation of any urgent care facilities operated by the health maintenance organization; and
    3. (iii) The potential responsibility of subscribers and enrollees for payment for emergency services or nonemergency services rendered in a hospital emergency facility;
  6. (6) A statement that shows, by category, the percentage of members assisted by public funds;
  7. (7) The information required to be disclosed by § 15-1206 of the Insurance Article; and
  8. (8) Any other information that the Commissioner or the Department requires by rule or regulation.

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.

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