Md. Code Ann., Ins. § 15-1902
Contracts between carriers and clinically integrated organizations
Effective Oct 1, 2014Added by Acts 2010, c. 598, § 1, eff. July 1, 2010; Acts 2010, c. 599, § 1, eff. July 1, 2010. Amended by Acts 2014, c. 104, § 2, eff. Oct. 1, 2014.State of Maryland
(a) Notwithstanding any other provision of this article or the Health--General Article, a contract between a carrier and a clinically integrated organization may include a provision to pay:
- (1) for services associated with the coordination of covered medical services to qualifying individuals; and
- (2) a bonus, fee-based incentive, bundled fees, or other incentives to promote the efficient, medically appropriate delivery of covered medical services to qualifying individuals.
- (b) The Commissioner, in consultation with the Maryland Health Care Commission, may adopt regulations specifying the types of payments and incentives permissible under this section.
(c)
- (1) A carrier shall file a copy of a contract between the carrier and a clinically integrated organization with the Commissioner.
- (2) If the contract includes a provision to pay a bonus or other incentive that does not comply with § 15-113 of this title, the Commissioner shall provide a copy of the contract to the executive director of the Maryland Health Care Commission.
(3) Notwithstanding any other provision of law, a copy of a contract filed with the Commissioner or provided by the Commissioner to the executive director of the Maryland Health Care Commission under this subsection, is:
- (i) confidential and privileged;
(ii) not subject to:
- 1. Title 4 of the General Provisions Article;
- 2. subpoena; or
- 3. discovery; and
- (iii) not admissible in evidence in any private action.
Added by Acts 2010, c. 598, § 1, eff. July 1, 2010; Acts 2010, c. 599, § 1, eff. July 1, 2010. Amended by Acts 2014, c. 104, § 2, eff. Oct. 1, 2014.