Md. Code, Health-Gen. § 19-716

Current with changes from the 2024 Legislative Session
Section 19-716 - Availability of information to members and general public

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.

Md. Code, HG § 19-716