Md. Code, Business Occupations and Professions § 19-306 — MD Code / Article gbo / Title 19 / Subtitle 3 / Section 19-306
§19–306.
Status: in_force

(a) (1) The Secretary shall issue a license to each applicant who meets the requirements of this subtitle.

(2) The Secretary shall issue an agency license certificate to each licensed security guard agency and a branch office certificate for each proposed branch office.

(b) (1) The Secretary shall include on each agency license certificate that the Secretary issues:

(i) the full name of the licensee;

(ii) the location of the principal office and of each branch office of the licensed security guard agency;

(iii) the date of issuance of the license;

(iv) the date on which the license expires; and

(v) the name of the representative member, if the licensee is a firm.

(2) The Secretary shall include on each branch office certificate:

(i) the full name of the licensee;

(ii) the location of the principal office of the licensee and of the agency branch office for which the certificate is issued;

(iii) the date of issuance of the branch office certificate;

(iv) the date on which the license of the licensee expires; and

(v) the name and agency address of the representative member, if the licensee is applying on behalf of a firm.
Md. Code, Health - General § 19-3A-02 — MD Code / Article ghg / Title 19 / Subtitle 3A / Section 19-3A-02
§19–3A–02.
Status: in_force

(a) On or before January 1, 2006, the Department shall adopt regulations for licensing a freestanding medical facility that uses in its title or advertising the word “emergency” or other language indicating to the public that medical treatment for immediately life-threatening medical conditions is available at that freestanding medical facility.

(b) The regulations shall require the freestanding medical facility to:

(1) Be open 24 hours a day, 7 days a week;

(2) Have available at all times:

(i) At least 1 physician who is credentialed in emergency medicine by the hospital of which the freestanding medical facility is an administrative part;

(ii) A sufficient number of registered nurses and other health care professionals to provide advanced life support;

(iii) Basic diagnostic and laboratory facilities and technicians;

(iv) Resuscitation supplies and equipment, including monitors, defibrillators, cardiac medications, intubation equipment, and intravenous line equipment;

(v) A commercial ambulance for transport of individuals in need of hospitalization or other emergency care; and

(vi) Emergency services to all individuals, regardless of ability to pay;

(3) Comply with all Maryland Institute for Emergency Medical Services Systems emergency transport protocols established for the freestanding medical facility;

(4) (i) Comply, except in a life–threatening emergency in which compliance is not feasible or practicable, with the federal Centers for Disease Control and Prevention guidelines on universal precautions; and

(ii) Display the notice developed under § 1–207 of the Health Occupations Article that explains the federal Centers for Disease Control and Prevention’s guidelines on universal precautions at the entrance to the freestanding medical facility;

(5) Refrain from use of the words “emergency department”, “emergency room”, or “hospital”; and

(6) Meet any other standard that the Secretary deems necessary to ensure the quality and safety of services provided by a freestanding medical facility.
Md. Code, Health - General § 19-385 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-385
§19–385.
Status: in_force

(a) This part may not be construed to:

(1) Affect the rights of an agent to make health care decisions under Title 5, Subtitle 6 of this article; or

(2) Create a private right of action against a hospital, a hospital employee, or a duly authorized agent of a hospital, or otherwise supersede or replace existing rights or remedies under any other State or federal law.

(b) No federal or State:

(1) Funds may be used for payment of a lay caregiver; and

(2) Program funding may be impacted by this part.
Md. Code, Health - General § 19-2503 — MD Code / Article ghg / Title 19 / Subtitle 25 / Section 19-2503
§19–2503.
Status: in_force

(a) On or before October 1, 2017, the credentialing entity shall submit a list to the Department of the recovery residences that have obtained a certificate of compliance.

(b) (1) On or before November 1, 2017, the Department shall publish on its website:

(i) A list of each credentialing entity and the contact information for the credentialing entity; and

(ii) A list of each recovery residence operating in each county in the State.

(2) The list published under paragraph (1)(ii) of this subsection shall indicate whether the owner of a recovery residence has received a valid certificate of compliance.

(c) (1) On or before November 1, 2017, a credentialing entity shall publish on its website a list of each recovery residence that holds a valid certificate of compliance.

(2) The list published under paragraph (1) of this subsection shall include only the owner of the recovery residence and the contact information of the owner.
Md. Code, Health - General § 19-716 — MD Code / Article ghg / Title 19 / Subtitle 7 / Section 19-716
§19–716.
Status: in_force

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, Health - General § 19-504 — MD Code / Article ghg / Title 19 / Subtitle 5 / Section 19-504
§19–504.
Status: in_force

Each center may:

(1) Establish any outpatient clinic for preadmission evaluation, aftercare, or other home health care service;

(2) Further medical knowledge by having a facility to explore new ways of treating problems peculiar to chronically ill and disabled individuals;

(3) Conduct any educational and training program to improve the knowledge and skills of physicians and ancillary professional, scientific, and other staff of the center and other treatment facilities and, thus, to improve a high standard of patient care; and

(4) Add a unit to treat chronic diseases of children.
Md. Code, Insurance § 19-111 — MD Code / Article gin / Title 19 / Subtitle 1 / Section 19-111
§19–111.
Status: in_force

(a) This section only applies if an insurer, through its insurance producer, adjuster, or representative, has begun investigating, estimating, or adjusting a property loss resulting from fire or a hazard under an extended coverage endorsement.

(b) (1) Except as provided in paragraph (2) of this subsection, an insured that has failed to give an insurer a sworn statement in proof of loss or a written notice as required by an insurance contract is not prevented from recovering under the insurance contract.

(2) An insured may be prevented from recovering under an insurance contract if the insured fails to provide the sworn statement in proof of loss or written notice required by the insurance contract within 15 days after receiving the insurer’s written request for the statement or notice.
Md. Code, Health - General § 19-509 — MD Code / Article ghg / Title 19 / Subtitle 5 / Section 19-509
§19–509.
Status: in_force

(a) (1) Each board consists of 7 members appointed by the Governor.

(2) The Governor shall appoint the members from a list of qualified individuals submitted to the Governor by the Secretary.

(b) Each member of the board for a center:

(1) Shall be a citizen of this State;

(2) Shall be a resident of a county that the center serves;

(3) Shall be representative of the community; and

(4) Shall be known for an interest in civic and public affairs and for concern about the care of chronically ill individuals.

(c) (1) The term of a member is 4 years.

(2) The terms of members are staggered as required by the terms provided for members of each board on July 1, 1982. The terms of those members end as follows:

(i) 1 in 1983.

(ii) 4 in 1984.

(iii) 1 in 1985.

(iv) 1 in 1986.

(3) At the end of a term, a member continues to serve until a successor is appointed and qualifies.

(4) A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.

(5) A member who serves 2 consecutive full 4-year terms may not be reappointed for 4 years after completion of those terms.
Md. Code, Health - General § 19-121 — MD Code / Article ghg / Title 19 / Subtitle 1 / Section 19-121
§19–121.
Status: in_force

(a) In this section, “health maintenance organization” means a health maintenance organization under Subtitle 7 of this title.

(b) (1) A health maintenance organization or a health care facility that either controls, directly or indirectly, or is controlled by a health maintenance organization shall have a certificate of need before the health maintenance organization or health care facility builds, develops, operates, purchases, or participates in building, developing, operating, or establishing:

(i) A hospital, as defined in § 19–301 of this title; and

(ii) Any other health care project for which a certificate of need is required under § 19–120 of this subtitle unless at least 90% of the patients who will receive health care services from the project will be individuals enrolled in that health maintenance organization.

(2) Notwithstanding paragraph (1)(ii) of this subsection, a health maintenance organization or a health care facility that either controls, directly or indirectly, or is controlled by a health maintenance organization is not required to obtain a certificate of need before purchasing an existing ambulatory surgical facility or center, as defined in § 19–114(b) of this subtitle.

(c) An application for a certificate of need by a health maintenance organization or by a health care facility that either controls, directly or indirectly, or is controlled by, a health maintenance organization shall be approved if the Commission finds that the application:

(1) Documents that the project is necessary to meet the needs of enrolled members and reasonably anticipated new members for the services proposed to be provided by the applicant; and

(2) Is not inconsistent with those sections of the State health plan or those sections of the institution–specific plan that govern hospitals, as defined in § 19–301 of this title, and ambulatory surgical facilities or centers, as defined in § 19–114(b) of this subtitle, or health care projects for which a certificate of need is required under subsection (b)(1)(ii) of this section.
Md. Code, Health Occupations § 19-316.1 — MD Code / Article gho / Title 19 / Subtitle 3 / Section 19-316.1
§19–316.
Status: in_force

§19–316.1.

The Board may issue a cease and desist order or obtain injunctive relief for a violation of any provision of § 19–301 of this subtitle or §§ 19–401 through 19–403 of this title.
Md. Code, Health - General § 19-4A-06 — MD Code / Article ghg / Title 19 / Subtitle 4A / Section 19-4A-06
§19–4A–06.
Status: in_force

The Department shall:

(1) Inspect the operations of each residential service agency to determine whether the agency is meeting the requirements of this subtitle and the regulations adopted under this subtitle; and

(2) Issue, deny, suspend, or revoke a residential service agency license in accordance with the regulations adopted under this subtitle.
Md. Code, Local Government § 19-230 — MD Code / Article glg / Title 19 / Subtitle 2 / Section 19-230
§19–230.
Status: in_force

(a) The financial officer may establish a separate rebate fund to be used to make any payments to the United States with respect to investment earnings on proceeds that may be required by the Internal Revenue Code.

(b) There may be separate accounts within the rebate fund.

(c) Amounts deposited to the rebate fund shall be used only for the purpose of making rebate payments, and no appropriation will be required before payment of any required rebates from the rebate fund to the United States.

(d) The financial officer may make payments from the rebate fund as required in order to:

(1) comply with the Internal Revenue Code; and

(2) maintain the exclusion from gross income for federal income tax purposes of interest on the bonds.

(e) Any excess money held in the rebate fund with respect to an issue of bonds after all required rebate payments for that issue have been made, as certified by the financial officer, shall be applied in a manner consistent with the Internal Revenue Code.
Md. Code, Business Occupations and Professions § 19-311 — MD Code / Article gbo / Title 19 / Subtitle 3 / Section 19-311
§19–311.
Status: in_force

(a) (1) Within 5 days after the change, a licensee shall submit to the Secretary written notice of:

(i) the addition of a branch office; and

(ii) any change in the address or telephone number of an existing office.

(2) The licensee shall submit with the notice:

(i) the agency license certificate; and

(ii) if the proposed change affects an existing branch office, the branch office certificate for that office.

(3) The Secretary may:

(i) endorse the change on the agency license certificate and, if applicable, on the branch office certificate of the affected branch office; or

(ii) issue a new agency license certificate and, if applicable, a new branch office certificate, both of which shall set forth the same date as the original agency license certificate.

(b) Within 5 days after the occurrence, a firm shall submit to the Secretary written notice of:

(1) the withdrawal of any firm member; and

(2) the death of any firm member.
Md. Code, Business Occupations and Professions § 19-315 — MD Code / Article gbo / Title 19 / Subtitle 3 / Section 19-315
§19–315.
Status: in_force

(a) Except as otherwise provided in § 10-226 of the State Government Article, before the Secretary takes any final action under § 19-313 of this subtitle, the Secretary shall give the person against whom the action is contemplated an opportunity for a hearing before the Secretary.

(b) The Secretary shall give notice and hold the hearing in accordance with Title 10, Subtitle 2 of the State Government Article.

(c) The Secretary may administer oaths in connection with any proceeding under this section.

(d) The hearing notice to be given to the person shall be written and sent at least 10 days before the hearing.

(e) The person may be represented at the hearing by counsel.

(f) If, after due notice, the person against whom the action is contemplated fails or refuses to appear, nevertheless the Secretary may hear and determine the matter.
Md. Code, Insurance § 19-309 — MD Code / Article gin / Title 19 / Subtitle 3 / Section 19-309
§19–309.
Status: in_force

(a) Notwithstanding any other law to the contrary, an insurer, for any reason not prohibited by law, may terminate any policy or insurance contract for which an antiarson application or alternative antiarson application is required under this subtitle at any time within 90 days after the insurer accepts the antiarson application or alternative antiarson application.

(b) An insurer shall state the specific reasons for terminating a policy or insurance contract in the notice of termination to the insured.
Md. Code, Transportation § 19-103 — MD Code / Article gtr / Title 19 / Subtitle 1 / Section 19-103
§19–103.
Status: in_force

(a) (1) In this section the following words have the meanings indicated.

(2) “Emergency service” means:

(i) Responding to an emergency call;

(ii) Pursuing a violator or a suspected violator of the law; or

(iii) Responding to, but not while returning from, a fire alarm.

(3) “Emergency vehicle” has the same meaning as in § 11–118 of this article.

(b) An operator of an emergency vehicle, who is authorized to operate the emergency vehicle by its owner or lessee while operating the emergency vehicle in the performance of emergency service as defined in subsection (a) of this section shall have the immunity from liability described under § 5–639(b) of the Courts and Judicial Proceedings Article.

(c) (1) An owner or lessee of an emergency vehicle, including a political subdivision, is liable to the extent provided in § 5–639(c) of the Courts and Judicial Proceedings Article for any damages caused by a negligent act or omission of an authorized operator while operating the emergency vehicle in the performance of emergency service as defined in subsection (a) of this section.

(2) An owner or lessee of an emergency vehicle, including a political subdivision, shall have the immunity from liability described under § 5–639(c) of the Courts and Judicial Proceedings Article.

(d) A self–insured jurisdiction shall have the immunity from liability under this section as described under § 5–639(d) of the Courts and Judicial Proceedings Article.
Md. Code, Health - General § 19-119 — MD Code / Article ghg / Title 19 / Subtitle 1 / Section 19-119
§19–119.
Status: in_force

(a) The Commission shall develop and adopt an institution-specific plan to guide possible capacity reduction.

(b) The institution-specific plan shall address:

(1) Accurate bed count data for licensed beds and staffed and operated beds;

(2) Cost data associated with all hospital beds and associated services on a hospital-specific basis;

(3) Migration patterns and current and future projected population data;

(4) Accessibility and availability of beds;

(5) Quality of care;

(6) Current health care needs, as well as growth trends for such needs, for the area served by each hospital;

(7) Hospitals in high growth areas; and

(8) Utilization.

(c) In the development of the institution-specific plan the Commission shall give priority to the conversion of acute capacity to alternative uses where appropriate.

(d) (1) The Commission shall use the institution-specific plan in reviewing certificate of need applications for conversion, expansion, consolidation, or introduction of hospital services in conjunction with the State health plan.

(2) If there is a conflict between the State health plan and any rule or regulation adopted by the Commission in accordance with Title 10, Subtitle 1 of the State Government Article to implement an institution-specific plan that is developed for identifying any excess capacity in beds and services, the provisions of whichever plan that is most recently adopted shall control.

(3) Immediately upon adoption of the institution-specific plan the Commission shall begin the process of incorporating the institution-specific plan into the State health plan and shall complete the incorporation within 12 months.

(4) A State health plan developed or adopted after the incorporation of the institution-specific plan into the State health plan shall include the criteria in subsection (b) of this section in addition to the criteria in § 19-118 of this subtitle.
Md. Code, State Finance and Procurement § 19-111 — MD Code / Article gsf / Title 19 / Subtitle 1 / Section 19-111
§19–111.
Status: in_force

(a) If the Commission determines that one or more allegations of a complaint filed under this title are false and that the complainant knew them to be false when filed, or that one or more of the allegations of a complaint are frivolous and without merit, the Commission may refuse to review or investigate any subsequent complaint filed by that complainant for a period of up to 3 years.

(b) When the totality of the evidence warrants action to deter future abuse of the protections made available under this title, the Commission may also recommend to the administrative law judge:

(1) that monetary sanctions be imposed against the complainant in the amount of the costs incurred by the State and the business entity in the investigation and review of the false or frivolous complaint, including reasonable attorneys’ fees; and

(2) that the complainant be disqualified from bidding and contract awards on State projects for a period of not more than 3 years.
Md. Code, Alcoholic Beverages and Cannabis § 19-1403 — MD Code / Article gab / Title 19 / Subtitle 14 / Section 19-1403
§19–1403.
Status: in_force

The Board shall obtain criminal history record information of each applicant for a license from the Central Repository.
Md. Code, Insurance § 19-116 — MD Code / Article gin / Title 19 / Subtitle 1 / Section 19-116
§19–116.
Status: in_force

(a) (1) In this section the following words have the meanings indicated.

(2) “Certificate holder” means any person, other than a policyholder, that requests, obtains, or possesses a certificate of insurance.

(3) (i) “Certificate of insurance” or “certificate” means any document or instrument, however titled or described, that is prepared or issued by an insurer or insurance producer as evidence of property insurance or casualty insurance coverage.

(ii) “Certificate of insurance” or “certificate” does not include a policy of insurance or an insurance binder.

(4) “Insurer” includes a person that is self–insured.

(5) “Person” includes a unit of State or local government.

(6) “Policyholder” means the owner of a policy of property insurance or casualty insurance.

(b) (1) This section applies to all certificate holders, policyholders, insurers, insurance producers, and certificates of insurance prepared or issued as evidence of insurance coverage on property, operations, or risks located in the State, regardless of where the certificate holder, policyholder, insurer, or insurance producer is located.

(2) This section may not be construed to apply to a statement, summary, or evidence of property insurance, including a certificate, required by a lender that holds a loan secured by:

(i) a mortgage;

(ii) a lien;

(iii) a deed of trust; or

(iv) any other security interest in real or personal property as security for the loan.

(c) (1) Except as provided in paragraphs (2) and (3) of this subsection, a person may not prepare or issue or require the preparation or issuance of a certificate of insurance unless the certificate of insurance form has been filed with and approved by the Commissioner.

(2) Any standard certificate of insurance form adopted by the Association for Cooperative Operations Research and Development (ACORD) or the Insurance Services Office (ISO) that otherwise complies with the requirements of this section is deemed approved by the Commissioner.

(3) The Commissioner may designate a certificate of insurance form required by a federal agency as deemed approved.

(d) The Commissioner shall disapprove a certificate of insurance form filed with the Commissioner under this section, or withdraw approval of a certificate of insurance form, if the form:

(1) is unjust, unfair, misleading, or deceptive or violates public policy;

(2) fails to comply with the requirements of this section; or

(3) violates any law, including any regulation adopted by the Commissioner.

(e) A person may not require an insurer or insurance producer to prepare or issue, or a policyholder to provide, a certificate of insurance that contains false or misleading information relating to the policy of insurance referenced in the certificate.

(f) A person may not alter or modify an approved certificate of insurance.

(g) A person may not prepare or issue a certificate of insurance that the person knows contains false or misleading information or that purports to amend, alter, or extend the coverage provided by the policy of insurance referenced in the certificate.

(h) A person may not prepare, issue, or require, either in addition to or in lieu of a certificate of insurance, an opinion letter or other document that is inconsistent with this section.

(i) (1) A certificate of insurance is not a policy of insurance and does not amend, alter, or extend the coverage provided by the policy of insurance referenced in the certificate.

(2) A certificate of insurance does not confer on a certificate holder new or additional coverage beyond the coverage provided in the policy of insurance referenced in the certificate.

(j) The terms and conditions of a notice of cancellation, nonrenewal, material change, or other similar matters relating to a policy of insurance referenced in a certificate of insurance:

(1) shall be governed by the policy of insurance; and

(2) may not be altered by a certificate of insurance.

(k) A certificate of insurance or any other document prepared, issued, or required in violation of this section is void and unenforceable.

(l) The Commissioner may examine and investigate the activities of any person that the Commissioner reasonably believes has been or is engaged in an act or practice prohibited by this section.

(m) The Commissioner shall adopt regulations to carry out this section, including regulations that establish an approval process for certificate of insurance forms.
Md. Code, Health - General § 19-377 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-377
§19–377.
Status: in_force

(a) In this section, “safe patient lifting” means the use of mechanical lifting devices by hospital employees, instead of manual lifting, to lift, transfer, and reposition patients.

(b) On or before December 1, 2007, each hospital shall establish a safe patient lifting committee with equal membership from management and employees.

(c) (1) On or before July 1, 2008, the safe patient lifting committee shall develop a safe patient lifting policy for the hospital.

(2) The goal of the policy shall be to reduce employee injuries associated with patient lifting.

(d) While developing a safe patient lifting policy, the committee shall consider, based on the patient population of that hospital, the appropriateness and effectiveness of:

(1) Developing or enhancing patient handling hazard assessment processes;

(2) Enhanced use of mechanical lifting devices;

(3) Developing specialized lift teams;

(4) Training programs for safe patient lifting required for all patient care personnel at the hospital;

(5) Incorporating physical space and construction design for mechanical lifting devices in any architectural plans for hospital construction or renovation; and

(6) Developing an evaluation process to determine the effectiveness of the policy.
Md. Code, Health - General § 19-1401.1 — MD Code / Article ghg / Title 19 / Subtitle 14 / Section 19-1401.1
§19–1401.
Status: in_force

§19–1401.1.

(a) (1) In addition to the requirements for licensure of a related institution as provided in this title, an applicant for licensure of a nursing home shall include in the application the identity of:

(i) Any person with an ownership interest in the nursing home; and

(ii) Any management company, landlord, or other business entity that will operate or contract with the applicant to manage the nursing home.

(2) (i) The person acquiring a nursing home shall provide the Department with written notice of the acquisition or change in operator at the same time as the notice required under § 19–120.2 of this title is filed with the Maryland Health Care Commission.

(ii) For other changes to the information required under paragraph (1) of this subsection, the nursing home shall notify the Department within 30 days after the effective date of the change.

(b) An applicant for licensure shall submit to the Secretary or the Secretary’s designee evidence:

(1) That affirmatively demonstrates the ability of the applicant to comply with minimum standards of:

(i) Medical care;

(ii) Nursing care;

(iii) Financial condition; and

(iv) Other applicable State or federal laws and regulations;

(2) Regarding the regulatory compliance history and financial condition of any health care facility owned or operated by the applicant in other jurisdictions; and

(3) That a request for acquisition for the nursing home was approved in accordance with § 19–120.2 of this title.
Md. Code, Health - General § 19-367 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-367
§19–367.
Status: in_force

(a) Either party aggrieved by the decision of the hearings office shall have the right to appeal that decision.

(b) A related institution subject to a sanction shall have the right to appeal a decision by the Secretary that the hazardous condition has not been corrected or that inadequate progress has been made toward correcting the hazardous condition.

(c) Such appeal shall be filed within 30 days of the action to be appealed.

(d) The appeal shall be taken directly to the circuit court of the jurisdiction in which the related institution is located.

(e) Appeal to the circuit court does not stay the imposition of the sanction.
Md. Code, Business Regulation § 19-204 — MD Code / Article gbr / Title 19 / Subtitle 2 / Section 19-204
§19–204.
Status: in_force

(a) Any fees that the Secretary of State establishes for registration, alteration, cancellation, research, and the issuance of certificates under this subtitle shall be as provided by law for similar services.

(b) The Secretary of State shall pay fees collected under this subtitle, less administrative costs, into the General Fund of the State.
Md. Code, Health Occupations § 19-317 — MD Code / Article gho / Title 19 / Subtitle 3 / Section 19-317
§19–317.
Status: in_force

(a) While investigating an allegation against a licensee under this title, the Board may require the licensee to submit to an appropriate examination by a health care provider designated by the Board if the Board has reason to believe that the licensee may cause harm to self or others.

(b) In return for the privilege given to a licensee to practice social work in the State, the licensee is deemed to have:

(1) Consented to submit to an examination under this section, if requested by the Board in writing; and

(2) Waived any claim of privilege as to the testimony or report of a health care provider who examines the licensee.

(c) The failure or refusal of the licensee to submit to an examination required under this section is prima facie evidence of the licensee’s inability to practice social work competently, unless the Board finds that the failure or refusal was beyond the control of the licensee.

(d) The Board shall pay the cost of any examination made under this section.
Md. Code, Local Government § 19-811 — MD Code / Article glg / Title 19 / Subtitle 8 / Section 19-811
§19–811.
Status: in_force

The principal amount of the bonds issued under this subtitle, the transfer of the bonds, the interest payable on the bonds, and any income derived from the bonds, including profit realized in the sale or exchange of the bonds, are exempt from State and local taxes.
Md. Code, Health - General § 19-403 — MD Code / Article ghg / Title 19 / Subtitle 4 / Section 19-403
§19–403.
Status: in_force

This subtitle does not:

(1) Limit the right of any person to practice a health occupation that the individual is authorized to practice under the Health Occupations Article;

(2) Limit the right of any person who holds a license under this article to act as authorized by that license; or

(3) Prohibit the care of an individual who relies on treatment in accordance with the tenets and practices of a recognized church or religious denomination and, with or without compensation, is cared for in accordance with those tenets and practices.
Md. Code, Health - General § 19-308 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-308
§19–308.
Status: in_force

(a) The Secretary shall adopt reasonable rules and regulations that set standards of services for related institutions, accredited hospitals, nonaccredited hospitals, accredited residential treatment centers, and nonaccredited residential treatment centers in the following areas:

(1) The care of patients;

(2) The medical supervision of patients;

(3) The physical environment;

(4) Disease control;

(5) Sanitation;

(6) Safety; and

(7) Dietary matters.

(b) (1) To assure compliance with the standards adopted under this subtitle, the Secretary shall have an inspection made:

(i) Of each related institution, each accredited hospital or nonaccredited hospital, and each accredited residential treatment center or nonaccredited residential treatment center for which a license is sought; and

(ii) Periodically of each related institution, each accredited hospital or nonaccredited hospital, and each accredited residential treatment center or nonaccredited residential treatment center for which a license has been issued.

(2) At least 2 inspections a year of each related institution shall be unannounced.

(3) The part of a building that contains part of a hospital, residential treatment center, or related institution and any outbuilding are considered part of the facility and are subject to inspection to determine occupancy status for licensing purposes.

(4) Subject to § 2–1257 of the State Government Article, during each regular session of the General Assembly, the Department shall submit to the General Assembly a report on the inspections.

(5) (i) An employee of the Department may not inform a hospital, residential treatment center, or related institution of any proposed inspection activity, unless the chief of the employee’s division directs the employee to do so.

(ii) An employee who violates any provision of this paragraph is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $1,000 or imprisonment not exceeding 1 year or both.
Md. Code, Health - General § 19-384 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-384
§19–384.
Status: in_force

A hospital’s discharge process may incorporate established evidence–based practices, including those described in:

(1) Standards for accreditation adopted by The Joint Commission or another nationally recognized hospital accreditation organization; and

(2) The Conditions of Participation for hospitals adopted by the Centers for Medicare and Medicaid Services.
Md. Code, Health - General § 19-1805.1 — MD Code / Article ghg / Title 19 / Subtitle 18 / Section 19-1805.1
§19–1805.
Status: in_force

§19–1805.1.

(a) To prevent irreparable harm to residents in a program, the Attorney General may seek injunctive relief on behalf of the State on the basis of an imminent or ongoing violation of a basic right of assisted living program residents provided under § 19–1805(a)(8)(i) through (viii) of this subtitle.

(b) In exercising the authority granted under this section, the Attorney General may not duplicate the corrective action imposed by the Department for the same violation.
Md. Code, Insurance § 19-706 — MD Code / Article gin / Title 19 / Subtitle 7 / Section 19-706
§19–706.
Status: in_force

(a) Subject to reasonable notice provisions contained in a policy or insurance contract, the notice provided to an insured under § 6-828(b)(1) of the Environment Article that a person at risk has an elevated blood lead level shall be deemed a claim against the insured for the purpose of triggering the authorized insurer’s duty to respond on behalf of the insured in accordance with Title 6, Subtitle 8, Part V of the Environment Article.

(b) Notwithstanding § 6-831 of the Environment Article and §§ 19-704 and 19-705 of this subtitle, an authorized insurer is not liable for a qualified offer made under Title 6, Subtitle 8, Part V of the Environment Article if the qualified offer was made in violation of the terms of the policy or insurance contract.
Md. Code, Health - General § 19-712.7 — MD Code / Article ghg / Title 19 / Subtitle 7 / Section 19-712.7
§19–712.
Status: in_force

§19–712.7.

To the extent required under federal law, a health maintenance organization shall reimburse a community health resource, as defined in § 19-2101 of this title, for covered services provided to a member or subscriber of the health maintenance organization.
Md. Code, Local Government § 19-101 — MD Code / Article glg / Title 19 / Subtitle 1 / Section 19-101
§19–101.
Status: in_force

(a) (1) In authorizing the sale of municipal bonds, the governing body of a county, the commissioners of finance for Baltimore City, and the commissioners of the Washington Suburban Sanitary Commission, by resolution, may provide that loans authorized to be incurred and bonds authorized to be sold by separate acts of enabling legislation be consolidated for sale and issued, sold, and delivered as a single issue of bonds, regardless of when the enabling legislation authorizing any loan or the sale of any bonds evidencing a loan was enacted.

(2) A resolution under paragraph (1) of this subsection is not a legislative act.

(b) (1) A consolidated issue of municipal bonds made under this section shall be designated as consolidated public improvement bonds of the issuing authority of the year in which the bonds are to be dated.

(2) A resolution authorizing the issuance and sale of consolidated public improvement bonds may specify all matters relating to the advertisement, sale, issuance, delivery, and payment of the bonds, including:

(i) the forms, dates, and denominations of the bonds;

(ii) the principal maturities;

(iii) the methods to be used in determining interest payable on the bonds; and

(iv) any provisions for:

1. registration;

2. redemption before stated maturity; and

3. the use of facsimile signatures or seals.

(c) (1) Notice of the public sale of consolidated public improvement bonds:

(i) shall be made at least once in a newspaper of general circulation in the county, Baltimore City, or the Washington Suburban Sanitary District; and

(ii) also may be made in a newspaper which circulates primarily among bankers and investors.

(2) At least one notice of public sale shall be made at least 10 days before the sale.

(d) After deduction of the expenses of the sale of consolidated public improvement bonds, the net proceeds shall be applied in the manner and for the purposes designated in the separate underlying acts of enabling legislation.

(e) The provisions of this section supersede any inconsistent provision of law.
Md. Code, Business Occupations and Professions § 19-316 — MD Code / Article gbo / Title 19 / Subtitle 3 / Section 19-316
§19–316.
Status: in_force

(a) Within 5 days after the Secretary suspends or revokes the license of a person, the person shall surrender to the Secretary the agency license certificate and each branch office certificate of the person.

(b) The Secretary may not refund to a person whose license is suspended or revoked any fee paid under this title.
Md. Code, Health - General § 19-22A-01 — MD Code / Article ghg / Title 19 / Subtitle 22A / Section 19-22A-01
§19–22A–01.
Status: in_force

The Secretary, in consultation with the State Department of Education and other stakeholders, shall develop guidelines to support the expansion of school–based health centers.
Md. Code, Insurance § 19-1001 — MD Code / Article gin / Title 19 / Subtitle 10 / Section 19-1001
§19–1001.
Status: in_force

(a) In this subtitle the following words have the meanings indicated.

(b) “Affiliated insurer” means:

(1) an insurer in the same corporate system as the insurer’s parent; or

(2) a member organization having common ownership, control, operation, or management with the insurer.

(c) “Aggregator site” means a website that provides access to information regarding insurance products from more than one insurer, including product and insurer information, for use in comparison shopping.

(d) “Blanket travel insurance” means a policy of travel insurance issued to any eligible group providing coverage for specific classes of persons defined in the policy with coverage provided to all members of the eligible group without a separate charge to individual members of the eligible group.

(e) “Cancellation fee waiver” means a noninsurance contractual agreement between a person engaged in the business of arranging or supplying travel and the person’s customer to waive some or all of a nonrefundable cancellation fee provision of the supplier’s underlying travel contract, with or without regard to the reason for cancellation or form of reimbursement.

(f) “Eligible group” means two or more persons who are engaged in a common enterprise or who have an economic, educational, or social affinity or relationship, including:

(1) an entity engaged in the business of providing travel or travel services in which, with regard to any particular travel or type of travel or travelers, all members or customers of the group have common exposure to risk attendant to that travel, including:

(i) a tour operator;

(ii) a lodging provider;

(iii) a vacation property owner;

(iv) a hotel or resort;

(v) a travel club;

(vi) a travel agency;

(vii) a property manager;

(viii) a cultural exchange program;

(ix) a common carrier; and

(x) the operator, owner, or lessor of a means of transportation of passengers, including:

1. an airline;

2. a cruise line;

3. a railroad;

4. a steamship company; and

5. a public bus carrier;

(2) a college, school, or any other institution of learning providing travel insurance coverage for students, teachers, employees, or volunteers;

(3) an employer providing travel insurance coverage for employees, volunteers, contractors, boards of directors, or dependents, or guests of those persons;

(4) a sports team, camp, or sponsor of a sports team or camp providing travel insurance coverage for participants, members, campers, employees, officials, supervisors, or volunteers;

(5) a religious, charitable, recreational, educational, or civic organization or branch of the religious, charitable, recreational, educational, or civic organization providing travel insurance coverage for members, participants, or volunteers;

(6) a financial institution or financial institution vendor, or parent holding company, trustee, or agent of, or designated by, a financial institution or financial institution vendor, providing travel insurance coverage for account holders, credit card holders, debtors, guarantors, or purchasers;

(7) an incorporated or unincorporated association, including a labor union, that:

(i) has a common interest, constitution, and bylaws;

(ii) is organized and maintained in good faith for purposes other than obtaining insurance for members or participants of the association; and

(iii) provides travel insurance coverage for members of the association;

(8) a trust or the trustees of a fund, subject to the Commissioner’s authorizing the use of a trust and the State’s premium tax provisions under § 6–102 of this article:

(i) established, created, or maintained for the benefit of members, employees, or customers of an association described under item (7) of this subsection; and

(ii) providing travel insurance coverage for members, employees, or customers of the association;

(9) an entertainment production company providing travel insurance coverage for participants, volunteers, audience members, contestants, or workers;

(10) a volunteer fire department, an ambulance, a rescue, a police, a court, or any other volunteer agency having jurisdiction as a first aid or civil defense group and providing travel insurance coverage for members, participants, or volunteers;

(11) a preschool, a day care institution for children or adults, or a senior citizen club providing travel insurance coverage for attendees or participants;

(12) an automobile or truck rental or leasing company:

(i) providing travel insurance coverage for individuals who may become renters, lessees, or passengers defined by the travel status of the individuals on the rented or leased vehicles; and

(ii) if the common carrier, operator, owner, or lessor of a means of transportation, or the automobile or truck rental or leasing company, is the policyholder or certificate holder of the travel insurance policy; and

(13) any other group for which the Commissioner determines that:

(i) the members of the group are engaged in a common enterprise or have an economic, educational, or social affinity or relationship; and

(ii) the issuance of the policy would not be contrary to the best interests of the public.

(g) “Fulfillment material” means documentation sent to the purchaser of a travel protection plan confirming the purchase and providing the travel protection plan’s assistance and coverage details, including access to the policy or certificate of coverage, as applicable.

(h) “Group travel insurance” means travel insurance that provides coverage for certificate holders of an eligible group under a travel insurance policy issued to a policyholder.

(i) “Limited lines travel insurance producer” has the meaning stated in § 10–101 of this article.

(j) “Offer and disseminate” has the meaning stated in § 10–101 of this article.

(k) (1) “Travel assistance services” means noninsurance services that do not result in any transfer or shifting of risk that would constitute the business of insurance.

(2) “Travel assistance services” includes:

(i) a security advisory service;

(ii) a destination information service;

(iii) a vaccination and immunization information service;

(iv) a travel reservation service;

(v) an entertainment service;

(vi) an activity and event planning service;

(vii) a translation assistance service;

(viii) an emergency messaging service;

(ix) an international legal and medical referral service;

(x) a medical case monitoring service;

(xi) coordination of transportation arrangements;

(xii) emergency cash transfer assistance;

(xiii) medical prescription replacement assistance;

(xiv) passport and travel document replacement assistance;

(xv) lost luggage assistance;

(xvi) a concierge service; and

(xvii) any other services that are furnished in connection with planned travel.

(l) “Travel insurance” has the meaning stated in § 10–101 of this article.

(m) “Travel protection plan” means a plan that provides, in addition to travel insurance:

(1) travel assistance services; or

(2) a cancellation fee waiver.

(n) “Travel retailer” has the meaning stated in § 10–101 of this article.
Md. Code, Health - General § 19-1401.3 — MD Code / Article ghg / Title 19 / Subtitle 14 / Section 19-1401.3
§19–1401.
Status: in_force

§19–1401.3.

(a) A licensee shall report to the Secretary or the Secretary’s designee any significant change in the financial condition of the nursing home, including cash flow or any other circumstances that could adversely affect the nursing home’s delivery of essential services to patients, including nursing services, dietary services, and utilities.

(b) Except as provided by subsection (c) of this section, any information obtained by the Secretary under this section is confidential and may not be disclosed without the consent of the licensee.

(c) The provisions of subsection (b) of this section do not apply to:

(1) The holder of a license that has been suspended or revoked; or

(2) The use of information in:

(i) An administrative proceeding initiated by the Department; or

(ii) A judicial proceeding.
Md. Code, Health - General § 19-108.6 — MD Code / Article ghg / Title 19 / Subtitle 1 / Section 19-108.6
§19–108.
Status: in_force

§19–108.6.

On or before December 1 every 4 years, beginning in 2026, the Commission shall submit a report to the Governor and, in accordance with § 2–1257 of the State Government Article, the General Assembly that includes:

(1) Advances or developments in the area of telehealth, including:

(i) Evolving modalities of telehealth delivery; and

(ii) Changes in the costs of delivering telehealth services; and

(2) Any findings or recommendations of the Commission.
Md. Code, Health - General § 19-724 — MD Code / Article ghg / Title 19 / Subtitle 7 / Section 19-724
§19–724.
Status: in_force

(a) Except as provided in subsection (b) of this section, a health maintenance organization may solicit members through advertising its services, charges, or nonprofessional aspects of its operation.

(b) A health maintenance organization may not use any advertising that makes any qualitative judgment about any person who provides services for a health maintenance organization.
Md. Code, Health - General § 19-344 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-344
§19–344.
Status: in_force

(a) To carry out the policy set forth in § 19-343 of this subtitle, the following procedures are required for all services provided to a resident of a facility.

(b) (1) A facility may not require or solicit, as a condition of admission into the facility, the signature of another person, other than the applicant, on the application or contract for admission to the facility, unless:

(i) The applicant is adjudicated disabled under Title 13, Subtitle 7 of the Estates and Trusts Article; or

(ii) 1. The applicant’s physician determines that the applicant is incapable of understanding or exercising the applicant’s rights and responsibilities; and

2. The applicant’s physician records, in the applicant’s facility record, the specific reasons for the determination.

(2) If, in addition to the signature of an applicant, a facility requires the signature of another person on the application or contract for admission to the facility in accordance with the provisions of paragraph (1) of this subsection, the facility shall provide a written statement to be included in the document of the rights, duties, and liabilities of the signer of the document.

(3) (i) A facility may request an applicant for whom a second signature cannot be required or solicited under paragraph (1) of this subsection to execute valid durable powers of attorney designating an attorney in fact to make financial, medical, funeral, and burial decisions in the event of the applicant’s disability.

(ii) A facility may not require the execution of a durable power of attorney as a condition or requirement of admission to the facility.

(c) (1) In this subsection, “agent” means a person who manages, uses, or controls the funds or assets that legally may be used to pay the applicant’s or resident’s share of costs or other charges for the facility’s services.

(2) Except as provided by the Department, a facility may not charge an applicant or resident who is a medical assistance beneficiary, or the applicant’s or resident’s agent, any amount in addition to the amounts determined by the medical assistance program for services that are covered by medical assistance.

(3) Unless otherwise agreed, the financial obligation of the applicant’s or resident’s agent is limited to the amount of the applicant’s or resident’s funds that are considered available to the agent by the medical assistance program.

(4) (i) A facility may require an applicant, a resident, or the agent of an applicant or resident to agree to distribute any funds, including income or assets of the applicant or resident, which the medical assistance program has determined to be available to pay for the cost of the applicant’s or resident’s care, to the facility, promptly when due, for the cost of the applicant’s or resident’s care.

(ii) For the purpose of this section, funds of the applicant or resident include funds of the applicant or resident that are under the use, ownership, management, or control of the agent.

(iii) A resident or agent of the resident who has not paid a current obligation for the resident’s care may apply to the medical assistance program for a determination of the funds available to pay for the cost of the resident’s care.

(iv) If a request for a determination is made under subparagraph (iii) of this paragraph, the medical assistance program shall make the determination.

(v) If a resident or agent of a resident who has not paid a current obligation for the resident’s care fails to request a determination under subparagraph (iii) of this paragraph, the facility may, without requesting the appointment of a guardian, petition the appropriate circuit court for an order or injunction directing the resident or agent of the resident to request and pursue the determination with due diligence or granting other appropriate relief to enforce the obligations under this section.

(vi) If a resident or agent of the resident fails to pay for the cost of the resident’s care from funds that the medical assistance program has determined to be available to pay for that care, the facility may, without requesting the appointment of a guardian, petition the appropriate circuit court for an order directing the resident or agent of the resident to pay the facility from the funds determined by the medical assistance program to be available.

(5) (i) An applicant, a resident, or the agent of an applicant or resident shall seek and pursue with due diligence, on behalf of the applicant or resident, all assistance from the medical assistance program which may be available to the applicant or resident.

(ii) The facility shall cooperate with and assist the agent in seeking assistance from the medical assistance program on behalf of the applicant or resident.

(iii) If a resident or the agent of a resident fails to seek assistance from the medical assistance program or to cooperate fully in the eligibility determination process, a facility providing care to the resident may, without requesting the appointment of a guardian, petition the appropriate circuit court for an order or injunction requiring the resident or agent of the resident to seek assistance from the medical assistance program or to cooperate in the eligibility determination process with due diligence or granting other appropriate relief to enforce the obligations under this section.

(6) (i) Any agent who willfully or with gross negligence violates the requirements of paragraph (4) of this subsection regarding the distribution of the applicant’s or resident’s funds is subject to a civil penalty not less than the amount of funds subject to the violation.

(ii) Any agent who willfully or with gross negligence violates the requirements of paragraph (5) of this subsection regarding an application for medical assistance by or on behalf of an applicant or resident is subject to a civil penalty not exceeding $10,000.

(iii) The Attorney General is responsible for the enforcement and prosecution of violations of the provisions of paragraphs (4) and (5) of this subsection.

(7) Nothing in this subsection may be construed to prohibit any person from knowingly and voluntarily agreeing to guarantee payment for the cost of an applicant’s care.

(d) Each facility shall:

(1) On or before admission of an individual, give the individual a written statement of:

(i) The services of the facility, including each service that is required to be offered on an as-needed basis; and

(ii) Related charges, including any charges for services that are not covered by Medicare, Medicaid, or the basic rate of the facility; and

(2) Keep a written receipt for the statement that is signed by the individual.

(e) Unless it is medically inadvisable, the resident physician of a facility or attending physician of its resident shall give the resident information about the diagnosis, treatment, and prognosis of the resident that is complete and current and is stated in language that the resident reasonably can be expected to understand.

(f) (1) A resident of a facility:

(i) Shall participate in the planning of the medical treatment;

(ii) May refuse medication or treatment; and

(iii) May know the medical consequences of these actions.

(2) The facility shall:

(i) Have the informed consent of a resident before the resident participates in any experimental research; and

(ii) Keep the resident’s written acknowledgment of that consent.

(3) The resident shall receive information about the relationship of the facility to other health care institutions if the information relates to the care of the resident.

(4) The resident shall receive reasonable continuity of care, including information as to the availability of physicians and times for medical appointments.

(g) (1) Any case discussion, consultation, examination, or treatment of a resident of a facility:

(i) Is confidential;

(ii) Is to be done discreetly; and

(iii) Is not open to an individual who is not involved directly in the care of the resident unless the resident permits the individual to be present.

(2) Except as necessary for the transfer of a resident from the facility to another health care institution or as required by law or a third-party payment contract, the personal and medical records of a resident are confidential and may not be released without the consent of the resident to any individual who:

(i) Is not associated with the facility; or

(ii) Is associated with the facility, but does not have a demonstrated need for the information.

(h) If it is feasible to do so and not medically contraindicated, spouses or domestic partners who are both residents of the facility shall be given the opportunity to share a room.

(i) A resident of a facility alone or with other individuals is entitled to present any grievance or recommend a change in a policy or service to the staff or administrator of the facility, the Department of Aging, or any other person, without fear of reprisal, restraint, interference, coercion, or discrimination.

(j) (1) Each facility shall place at the bedside of each resident the name, address, and telephone number of a physician who is responsible for the resident’s care.

(2) A resident shall have access at any reasonable time to a telephone where the resident may speak privately.

(3) A resident shall have access to writing instruments, stationery, and postage.

(4) The correspondence of a resident shall be sent to the addressee without delay and without being opened.

(5) Every patient and resident may associate and communicate privately and without restriction with persons and groups of his choice on his own or their initiative at any reasonable hour.

(k) (1) Each married resident of a facility shall have privacy during a visit by the spouse.

(2) Each resident of a facility who has a domestic partner shall have privacy during a visit by the other domestic partner.

(l) To a reasonable extent, a resident of a facility shall have the right to possess and use clothing and other personal effects and to have security for those effects.

(m) A resident of a facility may not be assigned to do any work for the facility without personal consent and without written approval of the attending physician of the resident.

(n) A resident of a facility shall receive a reasonable response from an administrator or staff to a personal request of the resident.

(o) (1) A resident of a facility shall enjoy privacy in the room of the resident.

(2) Unless the staff member knows that the resident is asleep, the member shall knock on the door before the member enters the room of the resident.

(p) The administrator of a facility is responsible for carrying out this section.

(q) (1) A resident of a facility or the next of kin or domestic partner or guardian of the person of a resident may file a complaint about an alleged violation of this section.

(2) The complaint may be filed with the Department of Aging or the Department.

(3) The Secretary of Aging shall:

(i) Investigate the complaint; and

(ii) After the investigation, report the findings to the complainant.

(4) After receipt of the report, the complainant shall be given an opportunity for a hearing before the Department in accordance with the rules and regulations that the Department adopts.

(5) The Secretary of Aging or the Secretary’s designee may request a hearing and act as a representative of the resident at the hearing under paragraph (4) of this subsection when:

(i) There is no guardian able and available or family member able, willing, and available; and

(ii) The resident consents.

(6) The Secretary of Aging or the Secretary’s designee may, in any hearing under paragraph (4) of this subsection to which it is not a party under paragraph (5) of this subsection, take part as an interested party.

(r) If a resident is adjudicated a disabled person, is found to be medically incompetent by the attending physician of the resident, or is unable to communicate with others, the rights of the resident may be exercised by:

(1) The next of kin of the resident;

(2) The guardian of the person of the resident;

(3) The sponsoring agency of the resident; or

(4) Unless the facility is the representative payee, the representative payee that the Social Security Administration designates for the resident.
Md. Code, Health Occupations § 19-501 — MD Code / Article gho / Title 19 / Subtitle 5 / Section 19-501
§19–501.
Status: in_force

This title may be cited as the “Maryland Social Workers Practice Act”.
Md. Code, Health Occupations § 19-404 — MD Code / Article gho / Title 19 / Subtitle 4 / Section 19-404
§19–404.
Status: in_force

In an attempt to obtain a license, a person may not intentionally give false information to the Board.
Md. Code, Health - General § 19-227 — MD Code / Article ghg / Title 19 / Subtitle 2 / Section 19-227
§19–227.
Status: in_force

(a) (1) Any person aggrieved by a final decision of the Commission under this subtitle may take a direct judicial appeal.

(2) The appeal shall be made as provided for judicial review of final decisions in the Administrative Procedure Act.

(b) (1) An appeal from a final decision of the Commission under this section shall be taken in the name of the person aggrieved as appellant and against the Commission as appellee.

(2) The Commission is a necessary party to an appeal at all levels of the appeal.

(3) The Commission may appeal any decision that affects any of its final decisions to a higher level for further review.

(4) On grant of leave by the appropriate court, any aggrieved party or interested person may intervene or participate in an appeal at any level.

(c) Any person, government agency, or nonprofit health service plan that contracts with or pays a facility for health care services has standing to participate in Commission hearings and shall be allowed to appeal final decisions of the Commission.
Md. Code, Health - General § 19-2101 — MD Code / Article ghg / Title 19 / Subtitle 21 / Section 19-2101
§19–2101.
Status: in_force

§19–2101. IN EFFECT

// EFFECTIVE UNTIL JUNE 30, 2035 PER CHAPTER 386 OF 2024 //

(a) In this subtitle the following words have the meanings indicated.

(b) “Affordable Care Act” means the federal Patient Protection and Affordable Care Act, as amended by the federal Health Care and Education Reconciliation Act of 2010, and any regulations adopted or guidance issued under the Acts.

(c) “Commission” means the Maryland Community Health Resources Commission.

(d) (1) “Community health resource” means a nonprofit or for profit health care center or program that offers the primary health care services required by the Commission under § 19–2109(a)(2) of this subtitle to an individual on a sliding scale fee schedule and without regard to an individual’s ability to pay.

(2) “Community health resource” includes:

(i) A federally qualified health center;

(ii) A federally qualified health center “look–alike”;

(iii) A community health center;

(iv) A migrant health center;

(v) A health care program for the homeless;

(vi) A primary care program for a public housing project;

(vii) A local nonprofit and community–owned health care program;

(viii) A school–based health center;

(ix) A teaching clinic;

(x) A wellmobile;

(xi) A health center controlled operating network;

(xii) A historic Maryland primary care provider;

(xiii) An outpatient behavioral health program; and

(xiv) Any other center or program identified by the Commission as a community health resource.
Md. Code, Health - General § 19-351 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-351
§19–351.
Status: in_force

(a) Except as provided in subsections (b) and (d) of this section, this subtitle does not affect the right of a hospital or related institution to employ or appoint staff.

(b) (1) A hospital or related institution that provides services that licensed podiatrists are authorized to perform under Title 16 of the Health Occupations Article, other than incidental care, shall include, in its bylaws, rules, or regulations, provisions for use of facilities by and staff privileges for qualified podiatrists.

(2) The hospital or related institution may restrict use of facilities and staff privileges by podiatrists to those podiatrists who meet the qualifications that the hospital or related institution sets for granting those privileges.

(3) The qualifications that the hospital or related institution sets for granting privileges for services that licensed podiatrists are authorized to perform under Title 16 of the Health Occupations Article shall include consideration of the training, education, and experience of the podiatrist.

(c) (1) A hospital or related institution shall include in its bylaws, rules, or regulations provisions for use of facilities by and staff privileges for qualified dentists.

(2) The hospital or related institution may restrict use of facilities and staff privileges by dentists to those dentists who meet the qualifications that the hospital or related institution sets for granting those privileges.

(d) (1) A hospital or related institution that provides services of the type that licensed psychologists are permitted to perform under Title 18 of the Health Occupations Article shall include in its bylaws, rules, or regulations, provisions for use of facilities by and staff privileges for qualified psychologists.

(2) The hospital or related institution may restrict use of facilities and staff privileges by psychologists to those psychologists who meet the qualifications that the hospital or related institution sets for granting those privileges.

(3) (i) Nothing in this subsection shall be construed to require a hospital to:

1. Grant admitting privileges to a psychologist; or

2. Permit the exercise of those privileges granted by the hospital board of trustees to psychologists without appropriate collaboration with the physician who has privileges to admit and attend patients in the unit of the facility where the patient is being treated and who has ongoing responsibility for the patient.

(ii) In the event of a disagreement between the psychologist and the physician concerning the patient’s treatment, the decision of the physician who has ongoing responsibility for the patient shall govern.
Md. Code, Local Government § 19-508 — MD Code / Article glg / Title 19 / Subtitle 5 / Section 19-508
§19–508.
Status: in_force

(a) A county fiscal officer who has custody of a sinking fund established by the county to pay the principal of or the interest on bonds issued in accordance with this subtitle may invest the sinking fund only as provided in § 19–102 of this title.

(b) A county fiscal officer who has custody of bond proceeds may invest the proceeds as provided in §§ 17–101 and 17–102 of this article.
Md. Code, Business Regulation § 19-205 — MD Code / Article gbr / Title 19 / Subtitle 2 / Section 19-205
§19–205.
Status: in_force

A registration under this subtitle is for the use, the benefit, and on behalf, of the organization, or a subsidiary or member in the State of the organization.
Md. Code, Health - General § 19-3B-03.1 — MD Code / Article ghg / Title 19 / Subtitle 3B / Section 19-3B-03.1
§19–3B–03.
Status: in_force

§19–3B–03.1.

(a) If a newborn is delivered in a freestanding birthing center following a high–risk pregnancy, the freestanding birthing center shall:

(1) Complete a postpartum infant and maternal referral form and submit the form to the local health department for the county in which the birthing parent resides;

(2) Provide to the birthing parent resources and information specific to the circumstances of the birthing parent, including information regarding the risks, signs, preventive measures, and treatment needs for postpartum complications, including cardiovascular conditions, chronic disease, substance misuse, and mental health conditions; and

(3) Call the birthing parent at least 24, but not later than 48, hours after discharging the parent to evaluate the parent’s status and, as necessary, provide information about postpartum complications.

(b) On or before October 1 each year, each local health department shall submit to the Department a report that includes the number and type of referrals made based on the referral forms submitted to the local health department in accordance with subsection (a)(1) of this section.
Md. Code, Local Government § 19-907 — MD Code / Article glg / Title 19 / Subtitle 9 / Section 19-907
§19–907.
Status: in_force

In any proceeding involving the validity or enforceability of pension liability funding bonds or any security for the bonds, a finding by the legislative or other governing body of the county or municipality as to the public purpose of any actions taken under this subtitle or as to other matters relating to the issuance of the bonds is conclusive.
Md. Code, State Finance and Procurement § 19-113 — MD Code / Article gsf / Title 19 / Subtitle 1 / Section 19-113
§19–113.
Status: in_force

Any party who, after having exhausted all administrative remedies available, is aggrieved by a final decision of the Commission or the administrative law judge may seek judicial review of such decision under § 10-222 of the State Government Article.
Md. Code, Health - General § 19-126 — MD Code / Article ghg / Title 19 / Subtitle 1 / Section 19-126
§19–126.
Status: in_force

(a) If the Commission receives an application for a certificate of need for a change in the bed capacity of a health care facility, as required under § 19–120 of this subtitle, or for a health care project that would create a new health care service or abolish an existing health care service, the Commission shall give notice of the filing by publication in the Maryland Register and give the following notice to:

(1) Each member of the General Assembly in whose district the action is planned;

(2) Each member of the governing body for the county where the action is planned;

(3) The county executive, mayor, or chief executive officer, if any, in whose county or city the action is planned; and

(4) Any health care provider, third party payor, local planning agency, or any other person the Commission knows has an interest in the application.

(b) Failure to give notice shall not adversely affect the application.

(c) (1) All decisions of the Commission on an application for a certificate of need, except in emergency circumstances posing a threat to public health, shall be consistent with the State health plan and the standards for review established by the Commission.

(2) The mere failure of the State health plan to address any particular project or health care service shall not alone be deemed to render the project inconsistent with the State health plan.

(3) Unless the Commission finds that the facility or service for which the proposed expenditure is to be made is not needed or is not consistent with the State health plan, the Commission shall approve an application for a certificate of need required under § 19–120(k) of this subtitle to the extent that the expenditure is to be made to:

(i) Eliminate or prevent an imminent safety hazard, as defined by federal, State, or local fire, building, or life safety codes or regulations;

(ii) Comply with State licensing standards; or

(iii) Comply with accreditation standards for reimbursement under Title XVIII of the Social Security Act or under the State Medical Assistance Program approved under Title XIX of the Social Security Act.

(d) (1) The Commission alone shall have final nondelegable authority to act upon an application for a certificate of need, except as provided in this subsection.

(2) A majority of the full authorized membership of the Commission shall be a quorum to act on an application for a certificate of need.

(3) After an application is filed, the staff of the Commission:

(i) Shall review the application for completeness within 10 working days of the filing of the application; and

(ii) May request further information from the applicant.

(4) The Commission may delegate to a reviewer the responsibility for review of an application for a certificate of need, including:

(i) The holding of an evidentiary hearing if the Commission, in accordance with criteria it has adopted by regulation, considers an evidentiary hearing appropriate due to the magnitude of the impact the proposed project may have on the health care delivery system; and

(ii) Preparation of a recommended decision for consideration by the full Commission.

(5) The Commission shall designate a single Commissioner to act as a reviewer for the application and any competing applications.

(6) The Commission shall delegate to its staff the responsibility for an initial review of an application, including, in the event that no written comments on an application are submitted by any interested party other than the staff of the Commission, the preparation of a recommended decision for consideration by the full Commission.

(7) Any “interested party” may submit written comments on the application in accordance with procedural regulations adopted by the Commission.

(8) The Commission shall define the term “interested party” to include, at a minimum:

(i) The staff of the Commission;

(ii) Any applicant who has submitted a competing application;

(iii) Any other person who can demonstrate that the person would be adversely affected by the decision of the Commission on the application;

(iv) A local health planning agency for a jurisdiction or region in which the proposed facility or service will be located; and

(v) In the review of a replacement acute general hospital project proposed by or on behalf of a regional health system that serves multiple contiguous jurisdictions, a jurisdiction within the region served by the regional health system that does not contain the proposed replacement acute general hospital project.

(9) The reviewer shall review the application, any written comments on the application, and any other materials permitted by this section or by the Commission’s regulations, and present a recommended decision on the application to the full Commission.

(10) (i) An applicant and any interested party may request the opportunity to present oral argument to the reviewer, in accordance with regulations adopted by the Commission, before the reviewer prepares a recommended decision on the application for consideration by the full Commission.

(ii) The reviewer may grant, deny, or impose limitations on an interested party’s request to present oral argument to the reviewer.

(11) Any interested party who has submitted written comments under paragraph (7) of this subsection may submit written exceptions to the proposed decision and make oral argument to the Commission, in accordance with regulations adopted by the Commission, before the Commission takes final action on the application.

(12) The Commission shall, after determining that the recommended decision is complete, vote to approve, approve with conditions, or deny the application on the basis of the recommended decision, the record before the staff or the reviewer, and exceptions and arguments, if any, before the Commission.

(13) The decision of the Commission shall be by a majority of the quorum present and voting.

(e) Where the State health plan identifies a need for additional hospital bed capacity in a region or subregion, in a comparative review of 2 or more applicants for hospital bed expansion projects, a certificate of need shall be granted to 1 or more applicants in that region or subregion that:

(1) Have satisfactorily met all applicable standards;

(2) (i) Have within the preceding 10 years voluntarily delicensed the greater of 10 beds or 10 percent of total licensed bed capacity to the extent of the beds that are voluntarily delicensed; or

(ii) Have been previously granted a certificate of need which was not recertified by the Commission within the preceding 10 years; and

(3) The Commission finds at least comparable to all other applicants.

(f) (1) If any party or interested person requests an evidentiary hearing with respect to a certificate of need application for any health care facility other than an ambulatory surgical facility and the Commission, in accordance with criteria it has adopted by regulation, considers an evidentiary hearing appropriate due to the magnitude of the impact that the proposed project may have on the health care delivery system, the Commission or a committee of the Commission shall hold the hearing in accordance with the contested case procedures of the Administrative Procedure Act.

(2) Except as provided in this section or in regulations adopted by the Commission to implement the provisions of this section, the review of an application for a certificate of need for an ambulatory surgical facility is not subject to the contested case procedures of Title 10, Subtitle 2 of the State Government Article.

(g) (1) An application for a certificate of need shall be acted upon by the Commission no later than 150 days after the application was docketed.

(2) If an evidentiary hearing is not requested, the Commission’s decision on an application shall be made no later than 90 days after the application was docketed.

(h) (1) The applicant or any aggrieved party, as defined in § 19–128(a) of this subtitle, may petition the Commission within 15 days for a reconsideration.

(2) The Commission shall decide whether or not it will reconsider its decision within 30 days of receipt of the petition for reconsideration.

(3) The Commission shall issue its reconsideration decision within 30 days of its decision on the petition.

(i) (1) Except as provided in paragraph (2) of this subsection, if the Commission does not act on an application within the required period, the applicant may file with a court of competent jurisdiction within 60 days after expiration of the period a petition to require the Commission to act on the application.

(2) (i) This paragraph does not apply to an application for a certificate of need involving:

1. The establishment of a health care facility;

2. The relocation of a health care facility; or

3. The introduction by a hospital of cardiac surgery or organ transplantation.

(ii) A certificate of need filed after October 1, 2019, shall be deemed approved if:

1. The certificate of need is uncontested; and

2. Final action by the Commission does not occur within 120 days after the application for the certificate of need was docketed.
Md. Code, Local Government § 19-905 — MD Code / Article glg / Title 19 / Subtitle 9 / Section 19-905
§19–905.
Status: in_force

(a) Notwithstanding any State or local law to the contrary, a county or municipality may:

(1) issue pension liability funding bonds:

(i) without regard to:

1. any provision of the county’s or municipality’s charter or any other law that:

A. requires a public referendum before the issuance of public debt by the county or municipality; or

B. requires that debt be issued only to finance certain projects such as capital projects defined in a charter; or

2. any other provision that is inconsistent with this subtitle;

(ii) in one or more series, each series being in the principal amount that the county or municipality determines to be required to achieve the purpose for the issuance of the pension liability funding bonds; and

(iii) as serial bonds or as term bonds with provisions for mandatory sinking fund or other annual principal redemption;

(2) sell pension liability funding bonds on a negotiated basis without solicitation of bids at a price at, above, or below par;

(3) provide for pension liability funding bonds to bear interest at fixed rates determined by the county or municipality or at floating or variable rates established by a method of determination approved by the county or municipality; and

(4) provide for the principal and interest installments on pension liability funding bonds to be unequal from year to year and to be consistent with the general financial plan of the county or municipality.

(b) A county or municipality may not issue pension liability funding bonds that mature later than 30 years from the date of issue.

(c) The first principal installment payment or mandatory redemption of any pension liability funding bonds may not be later than 3 years from the date of issue.
Md. Code, Health - General § 19-345.1 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-345.1
§19–345.
Status: reserved

§19–345.1.

(a) A facility shall provide the resident with written notice of:

(1) Any proposed discharge or transfer; and

(2) The opportunity for a hearing in accordance with the provisions of this section before the discharge or transfer.

(b) The Department shall prepare and provide each facility with a standardized form that provides, in clear and simple language, at least the following information:

(1) Notice of the intended discharge or transfer of the resident, including the proposed date of the intended discharge or transfer, which may change as a result of an appeal or the discharge planning process;

(2) Each reason for the discharge or transfer;

(3) The location to which the resident will be discharged or transferred, which may change as a result of an appeal or the discharge planning process;

(4) The name of the social worker or other professionally qualified staff, which may change during the discharge planning process, who:

(i) Is designated to provide social services and discharge planning services to the resident in connection with the discharge or transfer; and

(ii) Will be responsible for the development of the post discharge plan of care under subsection (g) of this section;

(5) A proposed date within 10 days after the date of the notice for a meeting between the resident, the resident’s representative, and facility staff to develop the post discharge plan of care under subsection (g) of this section;

(6) The right of the resident to request a hearing;

(7) The right of the resident to consult with any lawyer the resident chooses;

(8) The availability of the services of the Legal Aid Bureau, the Older American Act Senior Legal Assistance Programs, and other agencies that may provide assistance to individuals who need legal counsel;

(9) The availability of the Long–Term Care Ombudsman Program to assist the resident; and

(10) The provisions of this section.

(c) Except as otherwise provided in this section, at least 30 days before the facility involuntarily transfers or discharges a resident, the facility shall:

(1) Provide to the resident the written notice required under subsection (a) of this section; and

(2) Provide the written notice required under subsection (a) of this section to:

(i) The resident;

(ii) The next of kin, guardian, or any other individual known to have acted as the resident’s representative, if any;

(iii) The Long–Term Care Ombudsman; and

(iv) The Department.

(d) (1) (i) In accordance with regulations adopted by the Secretary, the facility shall provide the resident with an opportunity for a hearing on the proposed transfer or discharge.

(ii) The regulations adopted by the Secretary may provide for the establishment of an escrow account when:

1. The basis for the discharge is nonpayment; and

2. The resident continues to reside in the facility while the appeal is pending.

(2) Except as otherwise provided in this subsection, hearings on proposed transfers or discharges shall be conducted in accordance with the provisions of Title 10, Subtitle 2 of the State Government Article and the Medicaid Fair Hearing Procedures.

(3) Any hearing on a proposed discharge or transfer of a resident:

(i) Is not a contested case as defined in § 10–202 of the State Government Article; and

(ii) May not include the Secretary as a party.

(4) A decision by an administrative law judge on a proposed discharge or transfer of a resident:

(i) Is not a decision of the Secretary;

(ii) Unless appealed, is final and binding on the parties; and

(iii) May be appealed in accordance with § 10–222 of the State Government Article as if it were a contested case but the appeal does not automatically stay the decision of the administrative law judge.

(e) The facility shall provide the written notice required in subsection (a) of this section as soon as practicable before discharge or transfer if:

(1) An emergency exists and health or safety of the resident or other residents would be placed in imminent and serious jeopardy if the resident were not transferred or discharged from the facility as soon as possible; or

(2) The resident has not resided in the facility for 30 days.

(f) If the information in the notice provided under subsection (c) of this section changes before the discharge or transfer, the facility shall provide the changes to the recipients of the notice as soon as practicable after the new information becomes available.

(g) (1) Before any discharge or transfer and subject to paragraphs (4) and (5) of this subsection, a facility shall develop a post discharge plan of care for the resident to assist the resident with adjusting to the resident’s new living environment and that:

(i) Addresses the resident’s post discharge goals of care and treatment preferences; and

(ii) Identifies each of the resident’s reasonably anticipated medical and basic needs after discharge or transfer and establishes a plan for meeting those needs.

(2) The facility shall designate a social worker or other professionally qualified staff member to coordinate the development of the resident’s post discharge plan of care.

(3) The facility shall, if possible, meet with the resident and, with the resident’s consent, the resident’s representative within 10 days after providing the notice required under subsection (a) of this section to discuss the post discharge plan of care for the resident.

(4) (i) The resident’s post discharge plan of care shall be developed with the participation of the resident and, with the resident’s consent, the resident’s representative.

(ii) If the post discharge plan of care was developed without the participation of the resident or the resident’s representative, the facility shall include in the resident’s medical record an explanation of why the resident or the resident’s representative did not participate.

(5) The resident’s post discharge plan of care shall be developed in consultation with:

(i) The resident’s attending physician;

(ii) A registered nurse responsible for the care of the resident; and

(iii) Any other appropriate staff or professional involved with meeting the resident’s medical needs.
Md. Code, Health - General § 19-205 — MD Code / Article ghg / Title 19 / Subtitle 2 / Section 19-205
§19–205.
Status: in_force

(a) With the approval of the Governor, the Commission shall appoint an Executive Director, who is the chief administrative officer of the Commission.

(b) The Executive Director serves at the pleasure of the Commission.

(c) Under the direction of the Commission, the Executive Director shall perform any duty or function that the Commission requires.
Md. Code, Health - General § 19-303 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-303
§19–303.
Status: in_force

(a) (1) In this section the following words have the meanings indicated.

(2) “Commission” means the Health Services Cost Review Commission.

(3) (i) “Community benefit” means a planned, organized, and measured activity that is intended to meet identified community health needs within a service area.

(ii) “Community benefit” may include:

1. A community health service;

2. Health professional education;

3. Research;

4. A financial contribution;

5. A community–building activity, including partnerships with community–based organizations;

6. Charity care;

7. An activity described under subparagraph (i) of this paragraph that is funded by a foundation;

8. A mission–driven health service;

9. An operation related to an activity described under subparagraph (i) of this paragraph;

10. Financial or in–kind support of the Maryland Behavioral Health Crisis Response System; and

11. A community health worker workforce program established in accordance with § 19–303.1 of this subtitle.

(4) “Community Benefit Reporting Workgroup” means the Community Benefit Reporting Workgroup established in accordance with subsection (b) of this section.

(5) “Community health needs assessment” means the process required by the Affordable Care Act by which unmet community health care needs and priorities are identified by a nonprofit hospital in accordance with § 501(r)(3) of the Internal Revenue Code.

(b) (1) The Commission shall establish a Community Benefit Reporting Workgroup.

(2) The Community Benefit Reporting Workgroup shall be composed of individuals and stakeholder groups that have knowledge of and are impacted by hospital community benefit spending.

(c) The Commission shall adopt regulations to implement the recommendations of the Community Benefit Reporting Workgroup, that:

(1) Establish a standard format for reporting the information required under this subsection;

(2) Specify the date by which each nonprofit hospital is required to submit the annual community benefit report;

(3) Require each nonprofit hospital to solicit and take into account input received from individuals who represent the broad interests of that community, including individuals with special knowledge of or expertise in public and behavioral health in accordance with § 501(r)(3) of the Internal Revenue Code;

(4) Require each nonprofit hospital to conduct its community health needs assessment in consultation with community members as recommended by the Community Benefit Reporting Workgroup and to submit an annual community benefits report to the Commission detailing the community benefits provided by the hospital during the preceding year that includes:

(i) The mission statement of the hospital;

(ii) A list of the activities that were undertaken by the hospital to address the identified community health needs within the hospital’s community;

(iii) The cost to the hospital of each community benefit activity;

(iv) A description of how each of the listed activities addresses the community health needs of the hospital’s community;

(v) A description of efforts taken to evaluate the effectiveness of each community benefit activity;

(vi) A description of gaps in the availability of providers to serve the community;

(vii) A description of the hospital’s efforts to track and reduce health disparities in the community that the hospital serves;

(viii) A list of the unmet community health needs identified in the most recent community health needs assessment; and

(ix) A list of tax exemptions the hospital claimed during the immediately preceding taxable year, in accordance with State law.

(d) The Commission shall establish a method through which State and local governing bodies are made aware of the meetings of the Community Benefit Reporting Workgroup.
Md. Code, Health - General § 19-213 — MD Code / Article ghg / Title 19 / Subtitle 2 / Section 19-213
§19–213.
Status: in_force

(a) In this section, “facilities” means hospitals and related institutions whose rates have been approved by the Commission.

(b) The Commission shall assess and collect user fees on facilities as defined in this section.

(c) (1) The total fees assessed by the Commission may not exceed the greater of:

(i) 0.1% of the immediately preceding fiscal year’s budgeted, regulated, gross hospital revenue; or

(ii) The largest amount determined under this paragraph for a fiscal year during the immediately preceding 5 fiscal years.

(2) The total user fees assessed by the Commission may not exceed the Special Fund appropriation for the Commission by more than 20%.

(3) The user fees assessed by the Commission shall be used exclusively to cover the actual documented direct costs of fulfilling the statutory and regulatory duties of the Commission in accordance with the provisions of this subtitle and any administrative costs for services to the Commission provided by the Department.

(4) The Commission shall pay all funds collected from fees assessed in accordance with this section into the Health Services Cost Review Commission Fund.

(5) The user fees assessed by the Commission may be expended only for purposes authorized by the provisions of this subtitle.

(6) The amount specified in paragraph (1) of this subsection limits only the total user fees the Commission may assess in a fiscal year.

(d) (1) There is a Health Services Cost Review Commission Fund.

(2) The Fund is a special continuing, nonlapsing fund that is not subject to § 7–302 of the State Finance and Procurement Article.

(3) The Treasurer shall separately hold, and the Comptroller shall account for, the Fund.

(4) The Fund shall be invested and reinvested in the same manner as other State funds.

(5) Any investment earnings shall be retained to the credit of the Fund.

(6) The Fund shall be subject to an audit by the Office of Legislative Audits as provided for in § 2–1220 of the State Government Article.

(7) This section may not be construed to prohibit the Fund from receiving funds from any other source.

(8) (i) The Fund shall be used only to provide funding for the Commission and for the purposes authorized under this subtitle.

(ii) The costs of the Commission include the administrative costs incurred by the Department on behalf of the Commission.

(e) The Commission shall:

(1) Assess user fees for each facility equal to the sum of:

(i) The amount equal to one half of the total user fees times the ratio of admissions of the facility to total admissions of all facilities; and

(ii) The amount equal to one half of the total user fees times the ratio of gross operating revenue of each facility to total gross operating revenues of all facilities;

(2) Establish minimum and maximum assessments; and

(3) Assess each facility on or before June 30 of each year.

(f) (1) On or before September 1 of each year, each facility assessed under this section shall make payment to the Commission.

(2) The Commission shall make provision for partial payments.

(g) Any bill not paid within 30 days of an agreed payment date may be subject to an interest penalty to be determined by the Commission.

(h) (1) This section shall terminate and be of no effect on the first day of July following the cessation of a waiver by law or agreement for Medicare and Medicaid between the State of Maryland and the federal government.

(2) (i) If notice of intent to terminate is made by the federal government to this State before the first day of an intervening session of the Maryland General Assembly, this section shall expire June 30 of the following calendar year.

(ii) Under no circumstances shall less than 7 calendar months occur between notice of termination and expiration of this section.
Md. Code, Business Occupations and Professions § 19-308 — MD Code / Article gbo / Title 19 / Subtitle 3 / Section 19-308
§19–308.
Status: in_force

(a) By regulation, the Secretary shall stagger the terms of the licenses.

(b) Unless a license is renewed for a 3–year term as provided in this section, the license expires on the date the Secretary sets.

(c) At least 1 month before a license expires, the Secretary shall electronically transmit to the licensee a notice that states:

(1) the date on which the current license expires;

(2) that the Secretary must receive the renewal application and the statements required under § 19–309 of this subtitle, at least 15 days before the license expiration date, for the renewal to be issued and mailed before the license expires;

(3) the amount of the renewal fee;

(4) that, if the statements required under § 19–309 of this subtitle are not received at least 15 days before the license expiration date, a fee of $10 per day shall be charged against the licensee until the statements are received; and

(5) that the submission of a false statement in the renewal application or in the annual statements is cause for revocation of the license.

(d) A licensee periodically may renew the license for an additional 3–year term, if the licensee:

(1) otherwise is entitled to be licensed;

(2) pays to the Secretary in a method approved by the Secretary:

(i) a renewal fee of:

1. $200, if the licensee is an individual; or

2. $400, if the licensee is a firm;

(ii) payment for the cost of a fingerprint card record check by the Federal Bureau of Investigation; and

(iii) any late fee required under § 19–309 of this subtitle; and

(3) submits to the Secretary:

(i) a renewal application in the manner and format designated by the Secretary;

(ii) a complete set of the applicant’s legible fingerprints taken in a format approved by the Director of the Central Repository and the Director of the Federal Bureau of Investigation;

(iii) the statements required under § 19–309 of this subtitle and any other documentation that may be required by the Secretary to renew the agency license under this subtitle; and

(iv) two photographs of the applicant in a format approved by the Secretary.

(e) The Secretary shall renew the license of each licensee who meets the requirements of this section.
Md. Code, Health - General § 19-710 — MD Code / Article ghg / Title 19 / Subtitle 7 / Section 19-710
§19–710.
Status: reserved

(a) To qualify for a certificate of authority to operate as a health maintenance organization, an applicant shall satisfy the Commissioner that the applicant will meet the requirements of this section.

(b) The applicant shall conform to the definition of a health maintenance organization.

(c) The applicant shall establish and operate a bona fide health maintenance organization that can provide health care services in the proposed geographic area.

(d) (1) The health maintenance organization shall be actuarially sound.

(2) (i) Except as otherwise provided in this paragraph, the surplus that the health maintenance organization is required to have shall be paid in full.

(ii) The health maintenance organization licensed on or after July 1, 1989 shall have an initial surplus that exceeds the liabilities of the health maintenance organization by at least $1,500,000.

(iii) All health maintenance organizations shall maintain a surplus that exceeds the liabilities of the health maintenance organization in the amount that is at least equal to the greater of $750,000 or 5 percent of the subscription charges earned during the prior calendar year as recorded in the annual report filed by the health maintenance organization with the Commissioner.

(iv) No health maintenance organization shall be required to maintain a surplus in excess of a value of $3,000,000.

(3) (i) For the protection of the health maintenance organization’s members and creditors, the applicant shall deposit and maintain in trust with the State Treasurer $100,000 in cash or government securities of the type described in § 5–701(b) of the Insurance Article.

(ii) 1. The deposits shall be accepted and held in trust by the State Treasurer in accordance with Title 5, Subtitle 7 of the Insurance Article.

2. For the purpose of applying this subparagraph, a health maintenance organization shall be treated as an insurer.

(4) The Commissioner may waive the surplus and deposit requirements contained in this subsection if the Commissioner is satisfied that:

(i) The health maintenance organization has sufficient net worth and an adequate history of generating net income to assure financial viability for the next year;

(ii) The health maintenance organization’s performance and obligations are guaranteed by another person with sufficient net worth and an adequate history of generating net income; or

(iii) The assets of the health maintenance organization or contracts with insurers, governments, providers, or other persons are sufficient to reasonably assure the performance of the health maintenance organization’s obligations.

(e) The provisions of Title 4, Subtitle 3 (Risk Based Capital Standards for Insurers) and § 15–604 (Rates for Payments to Hospitals) of the Insurance Article apply to health maintenance organizations in the same manner as they apply to insurers.

(f) The terms of contracts, including any medical assistance program contracts under Title XVIII or Title XIX of the Social Security Act or Title III of the Public Health Service Act, proposed to be made or made with government or private agencies that cover all or part of the cost of subscriptions to provide health care services, facilities, appliances, medicines, or supplies shall be financially sound, based on reasonable actuarial assumptions that the health maintenance organization can meet its obligations to the agencies and their beneficiaries by reason of the health maintenance organization’s net worth position, stop loss, reinsurance arrangements with authorized insurers, or other arrangements that are satisfactory to the Commissioner.

(g) (1) The terms of the contracts to be offered to subscribers shall provide that the health care services provided to members of the health maintenance organization will meet reasonable standards of quality of care that are applicable to the geographic area to be served, as approved by the Department.

(2) If a health maintenance organization offers services that are within the scope of practice of a physician and another health care practitioner who is licensed under the Health Occupations Article, the health maintenance organization shall offer those services through other licensed health care practitioners, where appropriate, as determined by the health maintenance organization.

(h) (1) The procedures for offering health care services and offering and terminating contracts to subscribers may not discriminate unfairly on the basis of age, sex, sexual orientation, gender identity, religious beliefs, disability, race, health, or economic status.

(2) The requirement under paragraph (1) of this subsection does not prohibit:

(i) Reasonable underwriting classifications for establishing contract rates; or

(ii) Experience rating.

(i) (1) The terms of the agreements between a health maintenance organization and providers of health services shall contain a “hold harmless” clause.

(2) The hold harmless clause shall provide that the provider may not, under any circumstances, including nonpayment of money due the providers by the health maintenance organization, insolvency of the health maintenance organization, or breach of the provider contract, bill, charge, collect a deposit, seek compensation, remuneration, or reimbursement from, or have any recourse against the subscriber, member, enrollee, patient, or any persons other than the health maintenance organization acting on their behalf, for services provided in accordance with the provider contract.

(3) Collection from the subscriber or member of copayments or supplemental charges in accordance with the terms of the subscriber’s contract with the health maintenance organization, or charges for services not covered under the subscriber’s contract, may be excluded from the hold harmless clause.

(4) Each provider contract shall state that the hold harmless clause will survive the termination of the provider contract, regardless of the cause of termination.

(j) The health maintenance organization shall provide evidence of adequate insurance coverage or an adequate plan for self–insurance to satisfy claims for injuries that may occur from providing health care.

(k) The health maintenance organization shall provide for having its health and medical facilities and services audited and reviewed periodically:

(1) By personnel outside the health maintenance organization who:

(i) Act in a manner that is approved by the Department; and

(ii) Use methods that will assure objective evaluation and keep the identity of patients as confidential as possible;

(2) By the health maintenance organization’s own internal quality of care committee audit procedures, if the Department approves the procedures; or

(3) By a professional standards review organization, as described in Title XI of the Social Security Act, that is certified by the Department of Health and Human Services as capable of serving individuals in the area where the health maintenance organization operates who are receiving benefits under Title XVIII or Title XIX of the Social Security Act or Title III of the Public Health Service Act, if the professional standards review organization is acting consistently with its certification.

(l) (1) With the approval of the Department, the health maintenance organization shall provide continuous internal peer review for monitoring and evaluating patient records for:

(i) Quality of care; and

(ii) Overuse and underuse of provider care; and

(2) The health maintenance organization shall meet the requirements of Subtitle 13 of this title and all regulations for the performance of utilization review.

(m) The health maintenance organization shall provide an internal grievance system to resolve adequately any grievances initiated by any of its members, in a manner approved by the Department on matters concerning quality of care and by the Commissioner on all other matters covered by this subtitle, under rules and regulations adopted under this subtitle.

(n) The health maintenance organization shall establish procedures to offer each member an opportunity to participate in matters of policy and operation.

(o) The health maintenance organization shall maintain a health and medical records system that:

(1) Under procedures assuring maximum confidentiality, is readily accessible to authorized persons;

(2) Can accurately document use by each member; and

(3) At a minimum:

(i) Identifies clearly each patient by:

1. Name;

2. Number;

3. Age; and

4. Sex; and

(ii) Shows clearly:

1. The services provided;

2. When the services are provided;

3. Where the services are provided;

4. By whom the services are provided;

5. The diagnosis and prognosis, if appropriate;

6. The treatment;

7. Any drug therapy; and

8. The health status of the patient, if appropriate.

(p) (1) Except as provided in paragraph (3) of this subsection, individual enrollees and subscribers of health maintenance organizations issued certificates of authority to operate in this State may not be liable to any health care provider for any covered services provided to the enrollee or subscriber.

(2) (i) A health care provider or any representative of a health care provider may not collect or attempt to collect from any subscriber or enrollee any money owed to the health care provider by a health maintenance organization issued a certificate of authority to operate in this State.

(ii) A health care provider or any representative of a health care provider may not maintain any action against any subscriber or enrollee to collect or attempt to collect any money owed to the health care provider by a health maintenance organization issued a certificate of authority to operate in this State.

(3) Notwithstanding any other provision of this subsection, a health care provider or representative of a health care provider may collect or attempt to collect from a subscriber or enrollee:

(i) Any copayment or coinsurance sums owed by the subscriber or enrollee to a health maintenance organization issued a certificate of authority to operate in this State for covered services provided by the health care provider;

(ii) If Medicare is the primary insurer and a health maintenance organization is the secondary insurer, any amount up to the Medicare approved or limiting amount, as specified under the Social Security Act, that is not owed to the health care provider by Medicare or the health maintenance organization after coordination of benefits has been completed, for Medicare covered services provided to the subscriber or enrollee by the health care provider; or

(iii) Any payment or charges for services that are not covered services.

(q) (1) The Commissioner shall require each health maintenance organization to have an insolvency plan by January 1, 1990 which provides for:

(i) Continuation of benefits to subscribers and enrollees for the duration of the contract period for which premiums have been paid; and

(ii) Continuation of benefits to subscribers or enrollees who are admitted to an inpatient health care facility on the date of insolvency until, the earlier of:

1. The subscriber or enrollee is discharged from the inpatient health care facility; or

2. 365 days.

(2) In determining the adequacy of any insolvency plan, the Commissioner may consider:

(i) The existence of insurance to cover expenses incurred in continuing benefits after an insolvency;

(ii) Provisions in provider contracts obligating providers to continue to provide services to enrollees or subscribers:

1. For the duration of the contract period for which premiums have been made; and

2. If admitted to an inpatient health care facility, until the enrollee or subscriber is discharged or 365 days, whichever occurs first;

(iii) Reserves;

(iv) Letters of credit;

(v) Guarantees; or

(vi) Any other arrangement to assure that benefits are continued in accordance with the provisions of paragraph (1) of this subsection.

(r) Repealed.

(s) (1) In this subsection, “practice profile” means a profile, summary, economic analysis, or other analysis of data concerning services rendered or utilized by a provider under contract with or employed by a health maintenance organization for the provision of health care services by the provider to enrollees or subscribers of the health maintenance organization.

(2) If a health maintenance organization uses a practice profile as a factor in its contract review to evaluate a provider’s status on a provider panel, the health maintenance organization shall disclose at the commencement and renewal of the contract and, not more often than annually, upon the request of the provider:

(i) A description of the criteria used to compile the practice profile concerning the provider; and

(ii) The manner in which the practice profile is used to evaluate the provider.

(3) The information provided under this subsection may not be used to create a cause of action.

(4) A health maintenance organization may not terminate a provider contract or provider’s employment with the health maintenance organization on the basis of a practice profile without first informing the provider of the findings of the practice profile and the provider specific data underlying those findings.

(t) A health maintenance organization may not by contract, or in any other manner, require a provider to indemnify the health maintenance organization or hold the health maintenance organization harmless from a coverage decision or negligent act of the health maintenance organization.
Md. Code, Alcoholic Beverages and Cannabis § 19-2302 — MD Code / Article gab / Title 19 / Subtitle 23 / Section 19-2302
§19–2302.
Status: in_force

(a) (1) On the death of a married license holder or a license holder that holds a license for the benefit of a partnership or corporation, on application to the Board, a new license shall be issued to:

(i) the surviving spouse;

(ii) the surviving partners for the benefit of the partnership; or

(iii) the senior surviving officer of the corporation for the benefit of the corporation.

(2) The new license shall be issued:

(i) for the balance of the license year; and

(ii) without further proceedings.

(b) A renewal license may be issued to the following if they are qualified to hold the license:

(1) the surviving spouse;

(2) the surviving partners of a partnership; or

(3) the senior surviving officer of a corporation for the benefit of the corporation.
Md. Code, Health - General § 19-901 — MD Code / Article ghg / Title 19 / Subtitle 9 / Section 19-901
§19–901.
Status: in_force

(a) In this subtitle the following words have the meanings indicated.

(b) “General hospice care program” means a coordinated, interdisciplinary program of hospice care services for meeting the special physical, psychological, spiritual, and social needs of dying individuals and their families, by providing palliative and supportive medical, nursing, and other health services through home or inpatient care during the illness and bereavement:

(1) To individuals who have no reasonable prospect of cure as estimated by a physician; and

(2) To the families of those individuals.

(c) “General license” means a license issued by the Secretary to operate a general hospice care program.

(d) “Home–based hospice care program” means a program that directly or through a contractual arrangement provides a hospice care program in the residence of the patient.

(e) “Hospice facility” means a facility that:

(1) Provides a hospice care program;

(2) Is separate from any other facility; and

(3) Admits at least 2 individuals who:

(i) Are unrelated; and

(ii) Have no reasonable prospect of a cure.

(f) “Limited hospice care program” means a coordinated, interdisciplinary program of hospice care services for meeting the special physical, psychological, spiritual, and social needs of dying individuals and their families, by providing palliative and supportive nonskilled services through a home–based hospice care program during illness and bereavement:

(1) To individuals who have no reasonable prospect of cure as estimated by a physician; and

(2) To the families of those individuals.

(g) “Limited license” means a license issued by the Secretary to operate a limited hospice care program.
Md. Code, Public Utilities § 19-105 — MD Code / Article gpu / Title 19 / Subtitle 1 / Section 19-105
§19–105.
Status: in_force

(a) A commissioner or employee of the Commission who receives an ex parte communication that concerns a case where a determination or decision is required by law to be made only after a public hearing for interested parties shall make the ex parte communication public and part of the record of the proceeding.

(b) A commissioner or employee of the Commission who receives an ex parte communication that concerns the merits of a case where the commissioner’s or employee’s determination or decision is required by law to be made only after a public hearing for interested parties shall:

(1) note the substance of an oral ex parte communication for the record; and

(2) place the substance of a written ex parte communication on the record.
Md. Code, Health - General § 19-705.6 — MD Code / Article ghg / Title 19 / Subtitle 7 / Section 19-705.6
§19–705.
Status: in_force

§19–705.6.

(a) If it is necessary to provide emergency services, authorization shall be presumed for utilizing the medical or surgical provider on call for unassigned patients or the appropriate specialist on call for the hospital on that date if:

(1) A telephone access system is not operational at the time of the call; or

(2) A member’s primary care provider or the specialist needed by a member cannot be determined within a reasonable time, as determined by the treating emergency physician but not to exceed 30 minutes after the initial documented call to the telephone access system.

(b) This section may not be construed to require a health maintenance organization to have contracted specialist providers at hospitals outside of the service area of the health maintenance organization.
Md. Code, Health - General § 19-333 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-333
§19–333.
Status: in_force

(a) In Part V of this subtitle the following words have the meanings indicated.

(b) “Affiliate” means:

(1) Each partner of a partnership;

(2) Each officer, director, and stockholder who has direct or indirect ownership or control of 10 percent or more of the stock of a corporation; or

(3) Each individual who has direct or indirect ownership of 10 percent or more of a nursing home or community program.

(c) “Community program” means:

(1) A program which provides residential services and is an alcohol abuse and drug abuse treatment program as defined in § 8-403(a) of this article;

(2) A program which provides residential services for individuals with a developmental disability as defined in § 7-101(d) and (h) of this article;

(3) A private group home required to be licensed by the Secretary under § 10-517 of this article;

(4) A private therapeutic group home for children and adolescents as defined under § 10-920 of this article;

(5) A private residential treatment center for children and adolescents licensed under § 19-307 of this subtitle;

(6) A private facility operating living units that house less than 4 persons per unit under § 10-902 of this article;

(7) A program which provides day habilitation, vocational, or community supported living arrangements services required to be licensed under § 7-903 of this article; or

(8) A private program that provides outpatient services as set forth in § 10-902 of this article.

(d) “Individual” means a person who is a resident of a nursing home or a community residential program or a person enrolled in a day habilitation or vocational program.

(e) “Nursing home” means a related institution that is classified as a nursing home.
Md. Code, Business Regulation § 19-902 — MD Code / Article gbr / Title 19 / Subtitle 9 / Section 19-902
§19–902.
Status: in_force

(a) (1) In this section the following words have the meanings indicated.

(2) (i) “Battery–charged fence security system” means an alarm security system that includes a fence, a battery–operated energizer connected to the fence and intended to periodically deliver voltage impulses to the fence, a battery–charging device used exclusively to charge the battery, and any other ancillary components and attached equipment.

(ii) “Battery–charged fence security system” does not include:

1. deer fencing;

2. livestock fencing; or

3. a wireless security system as defined in § 19–901 of this subtitle.

(3) “Deer fencing” means fencing that is engineered to exclude or contain deer or elk.

(b) This section applies only to a battery–charged fence security system that:

(1) interfaces with a monitored alarm device in a manner that enables the alarm system to transmit a signal intended to alert the owner of the battery–charged fence security system or law enforcement;

(2) has an energizer that:

(i) is powered by a commercial storage battery that provides not more than 12 volts of direct current; and

(ii) meets the standards set forth in the International Electrotechnical Commission Standard 60335–2–76, current edition;

(3) is located:

(i) behind a nonelectric perimeter fence or wall that is at least 5 feet tall; and

(ii) on property that is not zoned as residential use only;

(4) is not taller than 10 feet or 2 feet taller than the height of the perimeter fence or wall, whichever is taller; and

(5) is marked with warning signs posted conspicuously on the fence at 30–foot intervals that state: “warning – electric fence”.

(c) (1) A local government may:

(i) require a person who provides a battery–charged fence security system to comply with a local alarm ordinance or obtain an alarm business registration or permit;

(ii) require a person who operates or causes to be operated a battery–charged fence security system to comply with a local alarm ordinance or obtain an alarm system registration or permit;

(iii) require an installer, on completion of a newly installed battery–charged fence security system, to submit to the local government an affidavit that includes:

1. the address of the installation;

2. the name of the installer;

3. the date of the installation; and

4. an affirmation that the criteria in subsection (b) of this section are satisfied; and

(iv) inspect the newly–installed battery–charged fence security system after receipt of an affidavit under item (iii) of this paragraph, if required.

(2) If, following an inspection conducted by a local government under paragraph (1)(iv) of this subsection, a battery–charged fence security system fails to comply with the criteria required under subsection (b) of this section, a local government may:

(i) issue a citation:

1. describing the specific noncompliance; and

2. requiring that the battery–charged fence security system be made compliant within a time period required by the local government; and

(ii) impose, if a battery–charged fence security system is not made compliant, a fine not exceeding $500.

(3) A local government may not:

(i) impose additional installation or operational requirements;

(ii) require a person described in paragraph (1) of this subsection to obtain an electrical permit;

(iii) prohibit the use of a battery–charged fence security system that is intended to be used for security; or

(iv) require additional permits or fees other than those described in paragraph (1) of this subsection.

(d) Battery–charged fence security systems are not exempt from Title 18 of the Business Occupations and Professions Article.
Md. Code, Alcoholic Beverages and Cannabis § 19-903 — MD Code / Article gab / Title 19 / Subtitle 9 / Section 19-903
§19–903.
Status: in_force

(a) There is a Class C beer, wine, and liquor license.

(b) The Board may issue the license for use by:

(1) a yacht club and country and golf club that:

(i) has been incorporated for at least 5 years before filing the application for the license;

(ii) has at least 250 members paying dues of at least $10 per year per adult member;

(iii) has facilities for preparing and serving food on the premises to members and guests when accompanied by members; and

(iv) owns or operates a clubhouse that is on the premises and principally used for its members and guests;

(2) a local unit of a nationwide nonprofit organization or club composed only of members who served in the armed forces of the United States in a war in which the United States has been engaged that:

(i) has a charter from a national veterans’ organization that was granted at least 5 years before the application for the license was made;

(ii) has at least 50 members paying dues of at least $5 per year per member;

(iii) operates only for the use of its members and guests when accompanied by members; and

(iv) meets in a clubhouse principally used for its members and guests;

(3) a lodge or chapter of a nonprofit and nationwide fraternal organization that:

(i) is composed of inducted members;

(ii) has been operating in the county for at least 5 years before the application for the license was made;

(iii) has at least 125 members paying dues of at least $5 per year per member; and

(iv) owns or operates a home or clubhouse principally for the use of its members and guests when accompanied by members; or

(4) a nonprofit organization operating on the premises located at 200 Byrn Street, Cambridge, known as Governors Hall at Sailwinds Park, so long as an individual or group of individuals does not derive personal profits from the operation of the organization.

(c) The license authorizes the license holder to sell beer, wine, and liquor at a club at the place described in the license, for on–premises consumption.

(d) When alcoholic beverages are served at an event open to the public at Governors Hall at Sailwinds Park, the license holder:

(1) may distribute a wristband at the event to each individual who is at least 21 years old; and

(2) if wristbands are distributed at the event, may not serve an alcoholic beverage to an individual who is not wearing a wristband.

(e) (1) The annual license fee is $1,000.

(2) The Board shall remit the license fee:

(i) if the licensed premises is in a municipality, to the governing body of the municipality; or

(ii) if the licensed premises is not in a municipality, to the Finance Department of the county.
Md. Code, Insurance § 19-301 — MD Code / Article gin / Title 19 / Subtitle 3 / Section 19-301
§19–301.
Status: in_force

In this subtitle, “antiarson application” means an application for property insurance covering the peril of fire that:

(1) requires an applicant to provide the basic information normally supplied to an insurer by an applicant for that type of coverage; and

(2) includes certain additional questions to be answered by the applicant.
Md. Code, Health - General § 19-215 — MD Code / Article ghg / Title 19 / Subtitle 2 / Section 19-215
§19–215.
Status: in_force

(a) (1) After public hearings and consultation with any appropriate advisory committee, the Commission shall adopt, by rule or regulation, a uniform accounting and financial reporting system that:

(i) Includes any cost allocation method that the Commission determines; and

(ii) Requires each facility to record its income, revenues, assets, expenses, outlays, liabilities, and units of service.

(2) Each facility shall adopt the uniform accounting and financial reporting system.

(b) In conformity with this subtitle, the Commission may allow and provide for modifications in the uniform accounting and financial reporting system to reflect correctly any differences among facilities in their type, size, financial structure, or scope or type of service.
Md. Code, Health - General § 19-347.1 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-347.1
§19–347.
Status: in_force

§19–347.1.

(a) In this section, “inappropriate sexual behavior” has the meaning stated in COMAR 10.01.18.02.

(b) A privately owned and operated residential treatment center shall be subject to the reporting requirements established by the Department under COMAR 10.01.18.05 that apply when a staff member observes, receives a complaint regarding, or otherwise has reason to believe that an individual has been subjected to inappropriate sexual behavior.
Md. Code, Health - General § 19-3B-02 — MD Code / Article ghg / Title 19 / Subtitle 3B / Section 19-3B-02
§19–3B–02.
Status: in_force

(a) A freestanding ambulatory care facility may not operate in the State unless the Secretary has granted the facility a license.

(b) The Secretary shall issue a license to an applicant that meets the requirements of this subtitle and all applicable regulations adopted by the Secretary.

(c) A license issued under this subtitle is not transferable.
Md. Code, Business Regulation § 19-301 — MD Code / Article gbr / Title 19 / Subtitle 3 / Section 19-301
§19–301.
Status: in_force

(a) In this subtitle the following words have the meanings indicated.

(b) (1) “Returnable container” means a device made of any material:

(i) that is used to hold, contain, or convert goods into a package, either by necessity or for convenience of delivery or sale;

(ii) that is suitable for repeated use; and

(iii) the title to which the seller does not intend to pass with the sale of the goods or the transport or return of the goods, as provided in item (2)(ii) of this section.

(2) “Returnable container” includes:

(i) a basket, tray, milk crate, or any type of container that is used by a bakery, dairy, distributor, retailer, food service establishment, or its agent, to transport, store, or carry goods including bakery or dairy products; and

(ii) a bag, box, basket, or any other device:

1. that is intended for repeated use;

2. that is used to hold or contain goods that are being:

A. transported to a laundry, dry cleaning, or dyeing establishment to be washed, laundered, dry cleaned, or dyed; or

B. returned to the person entitled to the return; and

3. the title to which the seller does not intend to pass by the transport or return of the goods.

(c) “Returnable textile” means a garment, towel, table linen, or bed linen with an identifying name, mark, or device woven, impressed, or produced on it, that is regularly supplied clean, and periodically exchanged for a similar soiled textile.
Md. Code, Public Utilities § 19-102 — MD Code / Article gpu / Title 19 / Subtitle 1 / Section 19-102
§19–102.
Status: in_force

(a) Except where provisions of this title exceed the minimum standards of the Maryland Public Ethics Law, commissioners and employees of the Commission are subject to the conflict of interest and lobbying provisions of the Maryland Public Ethics Law.

(b) Notwithstanding any other provision of law, a commissioner, employee, contractor, or subcontractor of the Commission may not willfully and knowingly violate:

(1) any provision of this title;

(2) the Maryland Public Ethics Law; or

(3) any Commission regulation governing:

(i) conflicts of interest;

(ii) financial disclosure;

(iii) lobbying; or

(iv) ethics in public contracting.
Md. Code, Insurance § 19-517.1 — MD Code / Article gin / Title 19 / Subtitle 5 / Section 19-517.1
§19–517.
Status: in_force

§19–517.1.

(a) Beginning July 1, 2017, and annually thereafter through July 1, 2021, the Commissioner shall make a determination whether, with regard to the required coverages under § 10–405(a) of the Public Utilities Article, there is a viable, affordable, and adequate market of authorized insurers in the State, including the Maryland Automobile Insurance Fund, available to provide the required coverages to the transportation network services industry.

(b) To the extent that the Commissioner makes an affirmative finding of availability, and in accordance with the provisions of Title 3, Subtitle 3 of this article, it is the intent of the General Assembly that required coverages be obtained from authorized insurers and the Maryland Automobile Insurance Fund.
Md. Code, Insurance § 19-203 — MD Code / Article gin / Title 19 / Subtitle 2 / Section 19-203
§19–203.
Status: in_force

An insurer that issues or delivers a policy or contract of homeowner’s liability insurance in the State shall offer to provide to a policyholder, who is registered as a family child care provider under Title 9.5, Subtitle 3 of the Education Article, coverage of at least $300,000 for liability that results from bodily injury, property damage, or personal injury arising out of an insured’s activities as a family child care provider.
Md. Code, Alcoholic Beverages and Cannabis § 19-2004 — MD Code / Article gab / Title 19 / Subtitle 20 / Section 19-2004
§19–2004.
Status: in_force

(a) A holder of a Class A beer and wine license may sell beer and wine:

(1) on Monday through Saturday, from 6 a.m. to midnight; and

(2) except as provided in § 19–2006 of this subtitle, on Sunday, from 6 a.m. to midnight.

(b) A holder of a Class B beer and wine (on–sale and off–sale) license may sell beer and wine:

(1) on Monday through Saturday, from 6 a.m. to 1:45 a.m. the following day; and

(2) except as provided in § 19–2006 of this subtitle, on Sunday from 10 a.m. to midnight.

(c) A holder of a Class C beer and wine license may sell beer and wine:

(1) on Monday through Saturday, from 6 a.m. to 1:45 a.m. the following day; and

(2) except as provided in § 19–2006 of this subtitle, on Sunday, from noon to midnight.

(d) A holder of a Class D beer and wine license may sell beer and wine:

(1) on Monday through Saturday, from 6 a.m. to 1:45 a.m. the following day; and

(2) except as provided in § 19–2006 of this subtitle, on Sunday from noon to 2 a.m. the following day.
Md. Code, Local Government § 19-807 — MD Code / Article glg / Title 19 / Subtitle 8 / Section 19-807
§19–807.
Status: in_force

(a) (1) A bond issued under this subtitle:

(i) shall be negotiable;

(ii) may be issued in coupon form or registrable as to principal or as to both principal and interest;

(iii) may be issued to bear interest, payable annually, semiannually, or otherwise; and

(iv) may be executed, issued, or delivered at any time.

(2) (i) A bond issued under this subtitle shall be signed by the president of the governing body of Cecil County.

(ii) The seal of the county shall be affixed to the bond and attested to by the clerk or the officer performing the functions of the clerk.

(iii) An officer’s signature or countersignature on a bond or coupon remains valid even if the officer ceases to be an officer before the delivery of the bond.

(3) (i) The county may not issue a bond under this subtitle that matures later than 40 years from the date of issue.

(ii) The county shall pay for a mature bond at the place that the county determines.

(b) Bonds issued under this subtitle may be secured by a pledge of mortgages or notes secured by deeds of trust on any type of interest in real or other property, including:

(1) real property or other interests held by stock cooperatives and condominiums and their unit owners;

(2) servicing agreements;

(3) condemnation proceeds;

(4) proceeds of private mortgage insurance or casualty and special hazard insurance; or

(5) any other security that Cecil County determines is appropriate.

(c) Bonds issued under this subtitle may provide that the bonds may be redeemed, at the option of Cecil County, before maturity, at the price and under the terms and conditions that the county sets before the bonds are issued.

(d) Money received from bonds issued under this subtitle may be used only to:

(1) make residential mortgage loans in Cecil County, either directly or through mortgage lending institutions;

(2) establish reserve funds;

(3) pay necessary financing expenses; or

(4) advance the payment of interest on the bonds during the 3 years after the date of the bonds.
Md. Code, Health - General § 19-713 — MD Code / Article ghg / Title 19 / Subtitle 7 / Section 19-713
§19–713.
Status: in_force

(a) (1) Each health maintenance organization shall file with the Commissioner and pay the applicable filing fee as provided in § 2–112 of the Insurance Article, before they become effective:

(i) All rates that the health maintenance organization charges subscribers or groups of subscribers; and

(ii) The form and content of each contract between the health maintenance organization and its subscribers or groups of subscribers.

(2) (i) A health maintenance organization that offers a health benefit plan, as defined in § 11–601 of the Insurance Article, is subject to Title 11, Subtitle 6 of the Insurance Article for the health benefit plan.

(ii) If the provisions of Title 11, Subtitle 6 of the Insurance Article conflict with the provisions of this section, the provisions of Title 11, Subtitle 6 of the Insurance Article shall prevail.

(b) (1) Rates of a health maintenance organization may not be excessive, inadequate, or unfairly discriminatory in relation to the services offered.

(2) A health maintenance organization that includes a subrogation provision in its contract as authorized under § 19-713.1(d) of this subtitle shall:

(i) Use in its rating methodology an adjustment that reflects the subrogation; and

(ii) Identify in its rate filing with the Maryland Insurance Administration, and annually in a form approved by the Insurance Commissioner, all amounts recovered through subrogation.

(c) (1) If, at any time, a health maintenance organization wishes to amend any contract with its subscribers or change any rate charged, the health maintenance organization shall file with the Commissioner the number of copies of the amendment or rate change that the Commissioner requires.

(2) The Commissioner shall provide the Department with the number of copies it requires.

(d) The Commissioner shall coordinate the contract and related rate filing review under this section.

(e) (1) If within 60 days after a filing made pursuant to this section, the Commissioner finds the filing does not meet the requirements of subsection (f) of this section, the filer shall be sent notice of disapproval specifying in what respects the Commissioner finds that the filing fails to meet the requirements of this section and stating that the filing shall not become effective.

(2) The Commissioner may extend the initial review period described in paragraph (1) of this subsection for up to an additional 30 days if the Commissioner gives notice to the health maintenance organization of the extension before the initial review period ends.

(3) The Commissioner may not issue a notice of disapproval of a filing under subsection (f) of this section without a statutory or regulatory basis for the disapproval and an explanation of the application of the statutory or regulatory basis which resulted in the disapproval.

(f) The Commissioner shall disapprove any form filed, or withdraw any previous approval, if the form:

(1) Is in any respect in violation or does not comply with this article or applicable regulations;

(2) Contains, or incorporates by reference, any inconsistent or inapplicable clauses, exceptions, or conditions which affect the risk purported to be assumed in the general coverage of the contract;

(3) Has any title, heading, or other indication of its provisions which is likely to mislead the subscriber or member;

(4) Includes provisions that are inequitable, or provisions that lack any substantial benefit to the subscriber or member;

(5) Is printed or otherwise reproduced in a manner as to render any provision of the form substantially illegible; or

(6) Provides benefits that are unreasonable in relation to the premium charged.

(g) (1) Except as provided in paragraph (2) of this subsection, unless the Commissioner disapproves a filing under this section, the filing becomes effective:

(i) 60 days after the office of the Commissioner receives the filing;

(ii) If the Commissioner extends the review period under subsection (e)(2) of this section, on the date specified in the notice required under subsection (e)(2) of this section; or

(iii) On any other date that the Commissioner sets.

(2) The Commissioner may adopt regulations to allow a type or kind of form to be effective upon receipt of the filing by the Commissioner.

(3) If a health maintenance organization uses a form which becomes effective in accordance with the provisions of paragraph (2) of this subsection and the form would be subject to disapproval under subsection (f) of this section, the Commissioner may:

(i) Subsequently disapprove the form; and

(ii) Find the health maintenance organization to be in violation of § 19–729 of this subtitle and impose a penalty as provided in § 19–730 of this subtitle.

(4) If a health maintenance organization files a form with the Commissioner which becomes effective in accordance with the provisions of paragraph (2) of this subsection, the health maintenance organization shall pay the applicable filing fee provided in § 2–112 of the Insurance Article.
Md. Code, Health Occupations § 19-308 — MD Code / Article gho / Title 19 / Subtitle 3 / Section 19-308
§19–308.
Status: in_force

(a) A license expires on the date set by the Board, unless the license is renewed for an additional term as provided in this section. A license may not be renewed for a term longer than 2 years.

(b) At least 1 month before the license expires, the Board shall send to the licensee, at the last known electronic or physical address of the licensee, a renewal notice that states:

(1) The date on which the current license expires;

(2) The date by which the renewal application must be received by the Board for the renewal to be issued and mailed before the license expires; and

(3) The amount of the renewal fee.

(c) Each licensee shall notify the Board of any change in the address of the licensee within 60 days after the change occurs.

(d) Before the license expires, the licensee periodically may renew it for an additional 2–year term, if the licensee:

(1) Otherwise is entitled to be licensed;

(2) Pays to the Board the appropriate renewal fee specified by this subtitle;

(3) Submits to the Board:

(i) A renewal application on the form that the Board requires; and

(ii) Satisfactory evidence of compliance with any continuing education requirement set under this section for license renewal; and

(4) Beginning in calendar year 2023 and except as provided in subsection (g)(3) of this section, attests that the licensee has submitted to a State and national criminal history records check in accordance with § 19–302.2 of this subtitle.

(e) (1) Subject to subsection (g) of this section, the Board shall renew the license of each licensee who meets the requirements of this section.

(2) The Board shall maintain the same information on each licensee.

(f) The Board may not renew a bachelor social worker license or a master social worker license of a licensee who holds a baccalaureate degree or master’s degree from a program that was a candidate for accreditation but was denied accreditation.

(g) (1) On receipt of the criminal history record information of an applicant for licensure forwarded to the Board in accordance with § 19–302.2 of this�subtitle, in determining whether disciplinary action should be taken, based on the criminal record information, against a licensee who renewed a license, the Board shall consider:

(i) The age at which the crime was committed;

(ii) The nature of the crime;

(iii) The circumstances surrounding the crime;

(iv) The length of time that has passed since the crime;

(v) Subsequent work history;

(vi) Employment and character references; and

(vii) Any other evidence that demonstrates whether the applicant poses a threat to the public health or safety.

(2) The Board may renew a license only if the licensee attests that the licensee has submitted to a criminal history records check under §�19–302.2 of this subtitle.

(3) Unless otherwise required, a renewal applicant who previously has completed the criminal history records check as required for the Board’s license renewal application process does not have to submit to a subsequent criminal history records check for license renewal.
Md. Code, Insurance § 19-206.1 — MD Code / Article gin / Title 19 / Subtitle 2 / Section 19-206.1
§19–206.
Status: in_force

§19–206.1.

(a) This section applies to an insurer that offers a homeowner’s insurance or renter’s insurance policy in the State that does not provide coverage for losses caused by specific breeds or specific mixed breeds of dogs.

(b) At the time of application for or issuance of a policy of homeowner’s insurance or renter’s insurance, and at each renewal of a policy of homeowner’s insurance or renter’s insurance, an insurer subject to this section shall provide to an applicant or an insured a written notice that:

(1) states that the policy does not provide coverage for losses caused by specific breeds or specific mixed breeds of dogs; and

(2) identifies the specific breeds or specific mixed breeds of dogs for which the policy does not provide coverage.

(c) An insurer subject to this section may provide the notice required under subsection (b) of this section in the annual statement required under § 19–205 of this subtitle.

(d) The notice required by this section may be delivered by electronic means if the insurer complies with the requirements of § 27–601.2 of this article.
Md. Code, Health - General § 19-2001 — MD Code / Article ghg / Title 19 / Subtitle 20 / Section 19-2001
§19–2001.
Status: in_force

(a) (1) In this subtitle the following words have the meanings indicated.

(2) “Client facility” means a health care facility that contracts with a health care staff agency for the referral of health care practitioners.

(3) “Health care facility” means a hospital or related institution as defined in § 19–301 of this title.

(4) (i) Except as provided in subparagraph (ii) of this paragraph, “health care practitioner” means any individual licensed or certified under the Health Occupations Article who:

1. Is a licensed practical nurse, registered nurse, or certified nursing assistant; or

2. Practices in an allied health care field, as defined by the Office in regulation.

(ii) “Health care practitioner” does not include:

1. An acupuncturist;

2. A dentist;

3. A nurse anesthetist;

4. A nurse midwife;

5. A nurse practitioner;

6. A pharmacist;

7. A physician; or

8. A podiatrist.

(5) (i) “Health care staff agency” means any person, firm, corporation, partnership, or other business entity engaged in the business of referring health care practitioners as employees or independent contractors to render temporary health care services at a health care facility in the State.

(ii) “Health care staff agency” does not include:

1. A health care staff agency operated by a health care facility or its affiliates solely for the purpose of procuring, furnishing, or referring temporary or permanent health care personnel for employment at that health care facility or its affiliates;

2. A home health agency regulated under Subtitle 4 of this title; or

3. Any health care practitioners procuring, furnishing, or referring their own services to a health care facility without the direct or indirect assistance of a health care staff agency.

(6) “Initially providing or referring” means the first time a health care staff agency provides or refers a particular health care practitioner to a health care facility.

(7) “Office” means the Office of Health Care Quality in the Department.

(8) “Responsible party” means the individual at a health care staff agency who controls the day to day operation of the health care staff agency.

(b) (1) A health care staff agency shall be licensed by the Office before referring health care practitioners to a health care facility to render temporary health care services at a health care facility in this State.

(2) All health care staff agencies shall submit to the Office:

(i) The health care staff agency’s:

1. Business name;

2. Business address;

3. Business telephone number; and

4. Responsible party; and

(ii) Any other information the Office requires by regulation to ensure compliance with the provisions of this subtitle.

(c) (1) A health care staff agency shall notify the Office of any change in ownership, agency name, or address within 30 days of the change.

(2) Notwithstanding the provisions of subsection (g)(1) of this section, if a health care staff agency fails to notify the Office within the time required under this subsection, the Office may impose a fine of $100.

(d) (1) Before initially providing or referring a health care practitioner to health care facilities to render temporary health care services, the health care staff agency shall verify the licensure or certification status of the health care practitioner.

(2) At the time a health care practitioner who is being referred to health care facilities by a health care staff agency must renew the health care practitioner’s license or certificate, the health care staff agency shall:

(i) Submit the name and license or certificate number of the health care practitioner to the Office; and

(ii) Verify the licensure or certification status of the health care practitioner.

(e) A health care staff agency may not knowingly provide or refer an individual who is not licensed or certified under the Health Occupations Article to a health care facility to render health care services.

(f) (1) Except as provided in paragraph (2) of this subsection:

(i) If a health care staff agency knows of an action or condition performed by a health care practitioner provided or referred by that health care staff agency that might be grounds for action relating to a license or certificate issued under the Health Occupations Article, the health care staff agency shall report the action or condition to the appropriate health occupation board; and

(ii) An individual shall have immunity from liability described under § 5–709 of the Courts and Judicial Proceedings Article for making a report as required under this paragraph.

(2) A health care staff agency is not required under this subsection to make any report that would be in violation of any federal or State law, rule, or regulation concerning the confidentiality of alcohol and drug abuse patient records.

(g) (1) Subject to the provisions of Title 10, Subtitle 2 of the State Government Article, the Office may impose a penalty for a violation of any provision of this section:

(i) For a first offense, up to $2,500 per violation or up to $2,500 per day until the health care staff agency complies with the requirements of this subtitle;

(ii) For a second offense, up to $5,000 per violation or up to $5,000 per day until the health care staff agency complies with the requirements of this subtitle; and

(iii) For a third or subsequent offense, up to $10,000 per violation or up to $10,000 per day until the health care staff agency complies with the requirements of this subtitle.

(2) Each day a violation continues is a separate violation.

(h) A health care staff agency is not a health care provider.
Md. Code, Insurance § 19-520 — MD Code / Article gin / Title 19 / Subtitle 5 / Section 19-520
§19–520.
Status: reserved

(a) (1) In this section the following words have the meanings indicated.

(2) “Car sharing delivery period” means the period of time during which a shared motor vehicle is being delivered to the location of the car sharing start time, as documented by the shared vehicle owner under a peer–to–peer car sharing program agreement.

(3) “Car sharing period” means the period of time that commences with the car sharing delivery period and ends at the car sharing termination time.

(4) “Car sharing start time” means the time when a shared motor vehicle becomes subject to the control of the shared vehicle driver at or after the time the reservation of a shared motor vehicle is scheduled to begin as documented in the records of a peer–to–peer car sharing program.

(5) “Car sharing termination time” means:

(i) the time when the shared motor vehicle is returned to the location designated by the shared vehicle owner through a peer–to–peer car sharing program; and

(ii) the earliest of the following occurs:

1. the expiration of the agreed period of time established for the use of the shared motor vehicle;

2. the intent to terminate the use of the shared motor vehicle is verifiably communicated to the peer–to–peer car sharing program; or

3. the shared vehicle owner, or the shared vehicle owner’s authorized designee, takes possession and control of the shared motor vehicle.

(6) “Intentional or fraudulent material misrepresentation” means an affirmative statement or an omission by a shared vehicle owner that misrepresents material facts about the shared vehicle owner or the shared motor vehicle.

(7) “Motor vehicle” has the meaning stated in § 11–135 of the Transportation Article.

(8) “Peer–to–peer car sharing” means the authorized use of a motor vehicle by an individual other than the vehicle’s owner through a peer–to–peer car sharing program.

(9) “Peer–to–peer car sharing program” means a platform that is in the business of connecting vehicle owners with drivers to enable the sharing of motor vehicles for financial consideration.

(10) “Peer–to–peer car sharing program agreement” means the written terms and conditions applicable to a shared vehicle owner and a shared vehicle driver that govern the use of a shared vehicle through a peer–to–peer car sharing program under the provisions of this section and Title 18.5 of the Transportation Article.

(11) “Shared motor vehicle” means a motor vehicle that is available for sharing through a peer–to–peer car sharing program.

(12) “Shared vehicle driver” means an individual who has:

(i) reserved the use of a shared motor vehicle through a peer–to–peer car sharing program; and

(ii) been authorized to drive the shared motor vehicle by the peer–to–peer car sharing program.

(13) “Shared vehicle owner” means the registered owner of a motor vehicle made available for sharing to shared vehicle drivers through a peer–to–peer car sharing program.

(b) (1) Solely on the basis that a motor vehicle is shared through a peer–to–peer car sharing program:

(i) a peer–to–peer car sharing program may not be considered to have rented the vehicle under Title 18, Subtitle 1 of the Transportation Article;

(ii) the shared vehicle owner may not be considered to have rented a vehicle under Title 18, Subtitle 1 of the Transportation Article; and

(iii) a peer–to–peer car sharing program may not be considered to be:

1. a rental vehicle company under § 18–108 of the Transportation Article; or

2. a motor vehicle rental company under Title 10, Subtitle 6 of this article.

(2) Subject to subsection (e)(1) of this section, the use of a shared motor vehicle through a peer–to–peer car sharing program does not constitute a commercial use solely on the basis that the motor vehicle is available for sharing or used through a peer–to–peer car sharing program.

(c) (1) (i) Except as provided in subparagraph (ii) of this paragraph, a peer–to–peer car sharing program shall assume the liability of a shared vehicle owner for any bodily injury or property damage to third parties or uninsured and underinsured motorist or personal injury protection losses during the car sharing period in an amount stated in the peer–to–peer car sharing program agreement, which amount may not be less than the minimum amount of security required under § 17–103 of the Transportation Article.

(ii) Except for the minimum security required under § 17–103 of the Transportation Article for any injured person who did not make the intentional or fraudulent misrepresentation, the assumption of liability under paragraph (1) of this subsection does not apply if the shared vehicle owner made an intentional or fraudulent material misrepresentation to the peer–to–peer car sharing program before the car sharing period in which the loss occurred.

(2) Nothing in paragraph (1) of this subsection:

(i) limits the liability of the peer–to–peer car sharing program for any act or omission of the peer–to–peer car sharing program itself that results in injury to any person as a result of the use of a shared motor vehicle through a peer–to–peer car sharing program; or

(ii) limits the ability of the peer–to–peer car sharing program to, by contract, seek indemnification from the shared vehicle owner or the shared vehicle driver for economic loss sustained by the peer–to–peer car sharing program resulting from a breach of the terms and conditions of the peer–to–peer car sharing program agreement.

(3) Each peer–to–peer car sharing program agreement made with respect to a car sharing arrangement in the State shall disclose to the shared vehicle owner and the shared vehicle driver:

(i) any right of the peer–to–peer car sharing program to seek indemnification from the shared vehicle owner or the shared vehicle driver for economic loss sustained by the peer–to–peer car sharing program resulting from a breach of the terms and conditions of the peer–to–peer car sharing program agreement;

(ii) that a motor vehicle liability insurance policy issued to the shared vehicle owner for the shared motor vehicle or to the shared vehicle driver does not provide a defense or indemnification for any claim asserted by the peer–to–peer car sharing program under item (i) of this paragraph;

(iii) that the peer–to–peer car sharing program’s insurance coverage on the shared vehicle owner and the shared vehicle driver is in effect only during each car sharing period and that, for any use of the shared motor vehicle by the shared vehicle driver after the car sharing termination time, the shared vehicle driver and the shared vehicle owner should contact the shared vehicle driver’s or the shared vehicle owner’s insurer about insurance coverage;

(iv) that the peer–to–peer car sharing program’s motor vehicle liability insurance policy may be exclusive for the shared vehicle owner and is primary for the shared vehicle driver, but may be secondary for the shared vehicle driver if the shared motor vehicle is used as a replacement vehicle, as defined in § 18.5–102(a)(2)(i) of the Transportation Article; and

(v) the daily rate, fees, any insurance costs, and any protection package costs that are charged to the shared vehicle owner or the shared vehicle driver.

(4) At the time when a vehicle owner registers as a shared vehicle owner on a peer–to–peer car sharing program and prior to the time when the shared vehicle owner makes a shared motor vehicle available for car sharing on the peer–to–peer car sharing program, the peer–to–peer car sharing program shall notify the shared vehicle owner that, if the shared motor vehicle has a lien against it, the use of the shared motor vehicle through a peer–to–peer car sharing program, including use without physical damage coverage, may violate the terms of the contract with the lienholder.

(d) (1) A peer–to–peer car sharing program shall ensure that, during each car sharing period, the shared vehicle owner and the shared vehicle driver are insured under a motor vehicle liability insurance policy that:

(i) recognizes that the vehicle insured under the policy is made available and used through a peer–to–peer car sharing program; and

(ii) provides the minimum security required under § 17–103 of the Transportation Article.

(2) The insurance described under paragraph (1) of this subsection may be satisfied by motor vehicle liability insurance maintained by:

(i) a shared vehicle owner;

(ii) a peer–to–peer car sharing program; or

(iii) both a shared vehicle owner and a peer–to–peer car sharing program.

(3) (i) A peer–to–peer car sharing program shall have an insurable interest in a shared motor vehicle during the car sharing period.

(ii) A peer–to–peer car sharing program may own and maintain as the named insured one or more policies of motor vehicle liability insurance that provides coverage in the amount of, in excess of, or optional to the minimum amount of coverage required to be provided under paragraph (1) of this subsection, including coverage for:

1. liabilities assumed by the peer–to–peer car sharing program under a peer–to–peer car sharing program agreement;

2. any liability of the shared vehicle owner;

3. damage or loss to the shared motor vehicle; and

4. any liability of the shared vehicle driver.

(iii) An offer by a peer–to–peer car sharing program to provide coverage to a shared vehicle driver in the amount of, in excess of, or optional to the minimum amount of coverage required to be provided under paragraph (1) of this subsection, whether on a stand–alone basis or as part of a financial protection package, shall be considered the sale or offer of insurance under Title 10, Subtitle 6A of this article.

(4) The insurance described under paragraph (1) of this subsection or authorized under paragraph (3) of this subsection shall:

(i) as to coverage of the shared vehicle driver, pay claims on a first dollar basis; and

(ii) be issued by:

1. an insurer authorized to do business in the State; or

2. solely with respect to insurance maintained by a peer–to–peer car sharing program under paragraph (3) of this subsection, an eligible surplus lines insurer:

A. in accordance with the requirements of Title 3, Subtitle 3 of this article; and

B. having an A.M. Best financial strength rating of A– or better.

(5) (i) The insurance described under paragraph (1) of this subsection shall, as to coverage of the shared vehicle owner, pay claims on a first dollar basis.

(ii) This paragraph may not apply to the terms and conditions under the insurance policy applicable to the peer–to–peer car sharing program.

(6) Consumer complaints concerning claims against a surplus lines policy issued in connection with, and incidental to, a peer–to–peer car sharing program agreement are subject to the Commissioner’s authority under § 27–303 of this article.

(7) (i) Except as provided in subparagraph (ii) of this paragraph, the motor vehicle liability insurance policy described in paragraph (1) of this subsection shall be primary with respect to the shared vehicle driver, but may be secondary to the shared vehicle driver’s motor vehicle liability insurance policy if the shared motor vehicle is used by the shared vehicle driver as a replacement vehicle, as defined in § 18.5–102(a)(2)(i) of the Transportation Article.

(ii) If the insurance maintained by the shared vehicle driver has lapsed, or is otherwise not in force, the peer–to–peer car sharing program’s insurance coverage required under paragraph (1) of this subsection shall be primary.

(e) (1) An authorized insurer that writes motor vehicle liability insurance in the State and the Maryland Automobile Insurance Fund may exclude any and all coverage and the duty to defend or indemnify for any claim afforded under a shared vehicle owner’s personal motor vehicle liability insurance policy for any loss or injury that occurs during the car sharing period.

(2) A motor vehicle insurer that defends or indemnifies a claim against a driver that is excluded under the terms of its policy shall have the right to seek contribution against the motor vehicle insurer of the peer–to–peer car sharing program if the claim is:

(i) made against the shared vehicle owner or the shared vehicle driver for loss or injury that occurs during the car sharing period; and

(ii) excluded under the terms of its policy.

(3) Nothing in this section invalidates or limits an exclusion contained in a motor vehicle liability insurance policy, including any insurance policy in use or approved for use before October 1, 2018, that excludes coverage for motor vehicles made available for rent, sharing, or hire or for any business use.

(4) The right to exclude any and all coverage and the duty to defend under paragraph (1) of this subsection applies to any coverage included in a motor vehicle liability insurance policy, including:

(i) liability coverage for bodily injury and property damage;

(ii) uninsured and underinsured motorist coverage;

(iii) medical payments coverage;

(iv) personal injury protection coverage;

(v) comprehensive physical damage coverage; and

(vi) collision physical damage coverage.

(f) (1) Except as provided in paragraph (2) of this subsection, a motor vehicle insurer may not deny, cancel, void, terminate, rescind, or nonrenew a personal motor vehicle liability insurance policy of a shared vehicle owner solely on the basis that a motor vehicle covered under the policy has been made available for sharing through a peer–to–peer car sharing program.

(2) A motor vehicle insurer may deny, cancel, void, terminate, rescind, or nonrenew a personal motor vehicle liability insurance policy covering a motor vehicle that has been made available for sharing through a peer–to–peer car sharing program if the applicant or policyholder of the personal motor vehicle liability insurance fails to provide complete and accurate information about the use of a shared motor vehicle through the peer–to–peer car sharing program as requested by the motor vehicle insurer during the application or renewal process of the motor vehicle liability insurance policy.

(g) Nothing in this section:

(1) requires any shared vehicle owner’s personal motor vehicle liability insurance policy to provide primary or excess coverage during the car sharing period;

(2) may be interpreted to imply that any shared vehicle owner’s personal motor vehicle liability insurance policy provides coverage for a motor vehicle during the car sharing period; or

(3) precludes a motor vehicle insurer from providing coverage for a shared vehicle owner’s vehicle while the vehicle is made available or used through a peer–to–peer car sharing program if the motor vehicle insurer elects to do so by contract or endorsement.

(h) (1) Coverage under a motor vehicle liability insurance policy maintained by a peer–to–peer car sharing program may not be dependent on the denial of a claim by another motor vehicle insurer.

(2) A motor vehicle insurer of a personal motor vehicle liability insurance policy may not be required to first deny a claim.

(i) A peer–to–peer car sharing program and a shared vehicle owner shall be exempt from vicarious liability in accordance with 49 U.S.C. § 30106 and under any state or local law that imposes liability solely based on vehicle ownership.

(j) In a claim coverage investigation following a vehicular accident, a peer–to–peer car sharing program shall cooperate to facilitate the exchange of information with directly involved parties and any motor vehicle insurer of a shared vehicle owner regarding the vehicle’s use in a peer–to–peer car sharing program.
Md. Code, Insurance § 19-306 — MD Code / Article gin / Title 19 / Subtitle 3 / Section 19-306
§19–306.
Status: in_force

(a) The Commissioner may require the use of an alternative antiarson application if, after a public hearing, the Commissioner finds that:

(1) there is an abnormally high incidence of arson in properties that are insured through a certain type of policy, are in a certain class of property, or are located in a certain geographic area of the State; and

(2) in accordance with this subtitle, the antiarson application described in § 19-305 of this subtitle was implemented with respect to that type of policy, class of property, or geographic area of the State.

(b) An alternative antiarson application may be mandated only for the types of policies, types of occupancies, and geographic areas of the State that otherwise would require the use of an antiarson application under this subtitle.
Md. Code, Local Government § 19-507 — MD Code / Article glg / Title 19 / Subtitle 5 / Section 19-507
§19–507.
Status: in_force

The principal of and interest on bonds issued in accordance with this subtitle are exempt from State and local taxes.
Md. Code, Local Government § 19-214 — MD Code / Article glg / Title 19 / Subtitle 2 / Section 19-214
§19–214.
Status: in_force

(a) A governmental entity may not issue bond anticipation notes under this part in a total principal amount that exceeds the authorized amount of the bonds in anticipation of the sale of which the notes are issued and sold.

(b) A governmental entity may not issue grant anticipation notes under this part in a total amount, including interest, that exceeds the amount of the grant in anticipation of the receipt of which the notes are issued and sold.
Md. Code, Health - General § 19-703 — MD Code / Article ghg / Title 19 / Subtitle 7 / Section 19-703
§19–703.
Status: in_force

(a) This subtitle does not:

(1) Authorize any person to engage directly or indirectly in the practice of any health occupation except as otherwise authorized by law;

(2) Authorize any person to regulate, interfere, or intervene in the relationship between any provider of health care services and the patients of the provider; or

(3) Prohibit any health maintenance organization from meeting the requirements of any federal law that authorizes the health maintenance organization to:

(i) Receive federal financial assistance; or

(ii) Enroll beneficiaries assisted by federal funds.

(b) A health maintenance organization or a part of it that is also a community health center organized under the federal Public Health Service Act and receives federal funds under 42 U.S.C. § 254c is not required to provide hospitalization for individuals for whom services are provided by those funds.

(c) Health maintenance organizations shall offer as an option to all of their members or subscribers benefits for hospice services provided by a hospice care program, as defined in § 19–901(c) of this title.

(d) Health maintenance organizations shall provide continuation coverage required under §§ 15–407 through 15–409 of the Insurance Article.

(e) Notwithstanding any other provision of this subtitle, a health maintenance organization may provide a limited set of health benefits if the limited set of health benefits is for subscribers or members who are enrolled in a county program to provide health care services for low–income individuals.

(f) (1) In addition to the requirements of § 15–10B–09 of the Insurance Article, whenever a mother is required to remain hospitalized after childbirth for medical reasons and the mother requests that the newborn remain in the hospital, a health maintenance organization shall provide as part of its hospitalization services provided to members and subscribers payment for the cost of additional hospitalization for the newborn for up to 4 days.

(2) The attending physician or certified nurse midwife of the mother, or the designee of the attending physician or certified nurse midwife, shall provide notice to the mother of the provisions of paragraph (1) of this subsection.
Md. Code, Insurance § 19-901 — MD Code / Article gin / Title 19 / Subtitle 9 / Section 19-901
§19–901.
Status: in_force

(a) In this subtitle the following words have the meanings indicated.

(b) “Covered customer” has the meaning stated in § 10–701 of this article.

(c) “Customer” has the meaning stated in § 10–701 of this article.

(d) “Portable electronics” has the meaning stated in § 10–701 of this article.

(e) “Portable electronics insurance” has the meaning stated in § 10–701 of this article.

(f) “Vendor” has the meaning stated in § 10–701 of this article.
Md. Code, Health - General § 19-1204 — MD Code / Article ghg / Title 19 / Subtitle 12 / Section 19-1204
§19–1204.
Status: in_force

A comprehensive rehabilitation facility shall meet any standard that the Secretary adopts by regulation.
Md. Code, Alcoholic Beverages and Cannabis § 19-2702 — MD Code / Article gab / Title 19 / Subtitle 27 / Section 19-2702
§19–2702.
Status: in_force

(a) A license holder or an employee of a license holder who is charged with a violation of § 6–304 of this article:

(1) shall receive a summons to appear in court on a certain day to answer the charges placed against the license holder or employee; and

(2) may not be required to post bail pending trial in any court in the State.

(b) A license holder or an employee of a license holder may not be found guilty of a violation of § 6–304 of this article if:

(1) the license holder or employee establishes to the satisfaction of the finder of fact that the license holder or employee used due caution to establish that the individual was not under the age of 21 years; and

(2) the individual was not a resident of the State.

(c) The granting of probation before judgment to a license holder or employee of the license holder for a violation of § 6–304 of this article does not bar the Board from proceeding administratively against the license holder for the violation.
Md. Code, Insurance § 19-701 — MD Code / Article gin / Title 19 / Subtitle 7 / Section 19-701
§19–701.
Status: in_force

(a) In this subtitle the following words have the meanings indicated.

(b) (1) “Affected property” means:

(i) 1. a residential rental property constructed before 1950 that contains not more than one rental dwelling unit; or

2. a residential rental property that contains not more than one rental dwelling unit for which the owner makes an election under § 6–803(a)(2) of the Environment Article; or

(ii) an individual rental dwelling unit within:

1. a residential rental property constructed before 1950 that contains more than one rental dwelling unit; or

2. a residential rental property that contains more than one rental dwelling unit for which the owner makes an election under § 6–803(a)(2) of the Environment Article.

(2) “Affected property” does not include property exempted under § 6–803(b) of the Environment Article.

(c) “Owner” has the meaning stated in § 6–801(o) of the Environment Article.

(d) “Rental dwelling unit” has the meaning stated in § 6–801(u) of the Environment Article.
Md. Code, Health - General § 19-722 — MD Code / Article ghg / Title 19 / Subtitle 7 / Section 19-722
§19–722.
Status: in_force

(a) The Commissioner may refuse to renew a certificate of authority for any reason for which the Commissioner may:

(1) Refuse to issue an original certificate; or

(2) Suspend or revoke an existing certificate.

(b) If the Commissioner refuses to renew a certificate of authority, the applicant has the same administrative and legal remedies as those provided under this subtitle for the suspension or revocation of a certificate of authority.
Md. Code, Health - General § 19-906 — MD Code / Article ghg / Title 19 / Subtitle 9 / Section 19-906
§19–906.
Status: in_force

(a) To qualify for a license, an applicant and the hospice care program and its medical director shall meet the requirements of this section.

(b) An applicant who is an individual, and any individual who is applying on behalf of a corporation, association, or government agency shall be:

(1) At least 18 years old; and

(2) Of reputable and responsible character.

(c) (1) Except for a limited licensee, the applicant shall have a certificate of need, as required under Subtitle 1 of this title, for the hospice care program to be operated.

(2) The Secretary, in consultation with the Maryland Health Care Commission, shall specify those jurisdictions in which a general hospice is authorized to provide home-based hospice services.

(3) A general hospice may not be licensed to provide home-based hospice services in a jurisdiction unless the general hospice or an entity acquired by the general hospice provided home-based hospice services to a patient in the jurisdiction during the 12-month period ending December 31, 2001.

(4) Notwithstanding paragraph (3) of this subsection:

(i) A general hospice may provide home-based hospice services to a specific patient outside of the jurisdictions in which the hospice is licensed if the Maryland Health Care Commission approves the service provision; and

(ii) A general hospice that is a hospital-based hospice or that had an affiliation agreement before April 5, 2003 with a health care facility or health care system may serve patients immediately upon discharge from the hospital, health care facility, or health care system, regardless of the jurisdiction in which the patient resides.

(5) Upon the notification by the Maryland Health Care Commission of the issuance of a certificate of need to a general hospice, the Secretary shall append to the general hospice license any additional jurisdictions in which the general hospice may provide home-based hospice services.

(6) The hospice care program to be operated and its medical director shall meet the requirements that the Secretary adopts under this subtitle.
Md. Code, Insurance § 19-305 — MD Code / Article gin / Title 19 / Subtitle 3 / Section 19-305
§19–305.
Status: in_force

(a) (1) The Commissioner shall adopt a two-tier antiarson application form that requires an applicant to complete a second-tier supplementary application if the initial first-tier application elicits certain predesignated answers.

(2) In adopting the antiarson application form, the Commissioner shall consider generally recognized two-tier application forms.

(b) An antiarson application shall include:

(1) the name and address of the applicant, any mortgagee, and any other party with an ownership interest in the property to be insured;

(2) the amount of insurance requested and the method of valuation used to establish that amount;

(3) the dates and selling prices of the property to be insured in all real estate transactions involving the property during the 3-year period immediately preceding the date of the antiarson application;

(4) the applicant’s history of losses during the 5-year period immediately preceding the date of the antiarson application with regard to any property:

(i) in which the applicant held an interest, including a partnership or mortgage interest, that is substantial; and

(ii) that sustained a fire loss exceeding 25% of the insured value;

(5) all taxes that are unpaid or overdue for 1 or more years; and

(6) the present occupancy of the property to be insured.
Md. Code, Health - General § 19-355 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-355
§19–355.
Status: in_force

(a) In this section, “gender identity” and “sexual orientation” have the meanings stated in § 20–101 of the State Government Article.

(b) This section does not prohibit a hospital or related institution that is licensed or otherwise regulated by the Department or a unit of the Department from refusing, withholding from, or denying any person services for failure to conform to the usual and regular requirements, standards, and regulations imposed by the licensed or regulated hospital or related institution, unless the refusal, withholding, or denial is based on discrimination on the grounds of race, color, religion, sex, age, national origin, marital status, sexual orientation, gender identity, or disability.

(c) A hospital or related institution may not discriminate against any individual with respect to the individual’s medical care because of the race, color, religion, sex, age, national origin, marital status, sexual orientation, gender identity, or disability of the individual.

(d) The Commission on Civil Rights shall enforce this section as provided in Title 20 of the State Government Article.
Md. Code, Education § 19-106 — MD Code / Article ged / Title 19 / Subtitle 1 / Section 19-106
§19–106.
Status: in_force

All money received by a system as proceeds from the sale of bonds authorized by this title and all money received by a system by way of auxiliary facilities fees or academic fees which are assigned or pledged as security for the bonds shall be deemed to be trust funds to be held and applied as provided by the provisions of this title.
Md. Code, Health - General § 19-510 — MD Code / Article ghg / Title 19 / Subtitle 5 / Section 19-510
§19–510.
Status: in_force

(a) From among its members, each board shall elect a chairman and other officers that the board considers necessary.

(b) The manner of election of officers and their terms of office shall be as the board determines.
Md. Code, Alcoholic Beverages and Cannabis § 19-501 — MD Code / Article gab / Title 19 / Subtitle 5 / Section 19-501
§19–501.
Status: in_force

Title 2, Subtitle 3 (“Wholesaler’s Licenses”) of Division I of this article applies in the county without exception or variation.
Md. Code, Alcoholic Beverages and Cannabis § 19-1103 — MD Code / Article gab / Title 19 / Subtitle 11 / Section 19-1103
§19–1103.
Status: in_force

(a) The Board may issue a nonrefillable container permit for draft beer to a holder of:

(1) a Class B beer license;

(2) a Class B beer and wine license;

(3) a Class B beer, wine, and liquor license;

(4) a Class D beer license;

(5) a Class D beer and wine license; or

(6) a Class D beer, wine, and liquor license.

(b) An applicant for the permit shall complete the form that the Board provides.

(c) The hours of sale for the permit:

(1) begin at the same time as those for the underlying license; and

(2) end at midnight.

(d) In an area of the licensed premises that is accessible to the public, the permit holder may not display or provide shelving for beer for off–premises consumption.

(e) The Board may adopt regulations to carry out this section, including limiting the number of nonrefillable container permits that may be issued in the county.

(f) (1) Except as provided in paragraph (2) of this subsection, the annual permit fees are:

(i) $50 for an applicant whose license has an off–sale privilege; and

(ii) $500 for an applicant whose license does not have an off–sale privilege.

(2) An applicant who has a refillable container permit may not be charged a fee for a nonrefillable container permit.
Md. Code, Commercial Law § 19-201 — MD Code / Article gcl / Title 19 / Subtitle 2 / Section 19-201
§19–201.
Status: in_force

(a) (1) Subject to § 19-203 of this subtitle, whenever a dealer enters into a contract in which the dealer agrees to maintain inventory and the contract is terminated by either party, the supplier shall repurchase the dealer’s inventory on the terms specified in § 19-202 of this subtitle unless the dealer chooses to keep the inventory.

(2) If the dealer has any outstanding debts to the supplier, the repurchase amount may be set off or credited to the dealer’s account.

(b) (1) If a dealer enters into a contract in which the dealer agrees to maintain inventory and the dealer or the majority stockholder of the dealer, if the dealer is a corporation, dies or is adjudicated incompetent, the supplier shall, at the option of the heir, personal representative, or guardian of the dealer, or the person that succeeds to the stock of the majority stockholder if the dealer is a corporation, repurchase the inventory as if the contract had been terminated.

(2) An heir, personal representative, guardian, or succeeding stockholder has 1 year from the date of the death or adjudication of incompetency of the dealer or majority shareholder to exercise the option provided under this subsection.
Md. Code, Health - General § 19-310 — MD Code / Article ghg / Title 19 / Subtitle 3 / Section 19-310
§19–310.
Status: in_force

(a) (1) In this subsection, “designated requestor” means a hospital employee who has completed a course offered by an organ, tissue, or eye recovery agency on how to approach potential donor families and request organ or tissue donation.

(2) (i) On or before the occurrence of each death in a hospital, the hospital shall contact an appropriate organ, tissue, or eye recovery agency in order to determine the patient’s suitability for organ, tissue, or eye donation.

(ii) The contact and its disposition shall be noted in the patient’s medical record.

(3) (i) The appropriate organ, tissue, or eye recovery agency, in consultation with the patient’s attending physician or the physician’s designee, shall determine the patient’s suitability for organ, tissue, or eye donation.

(ii) If the organ, tissue, or eye recovery agency, in consultation with the patient’s attending physician or the physician’s designee, determines that donation is not appropriate based on established medical criteria, this determination shall be noted by hospital personnel in the patient’s medical record and no further action is necessary.

(iii) If the organ, tissue, or eye recovery agency, in consultation with the patient’s attending physician or the physician’s designee, determines that the patient is a suitable candidate for organ, tissue, or eye donation, a representative of the appropriate organ, tissue, or eye recovery agency or a designated requestor shall initiate a request under paragraph (4) of this subsection, if applicable.

(4) (i) Except as provided in the Maryland Revised Uniform Anatomical Gift Act, when an individual dies in a hospital in accordance with § 5–202 of this article, a representative of the appropriate organ, tissue, or eye recovery agency or a designated requestor shall request, with sensitivity and in compliance with § 4–507 of the Estates and Trusts Article, that the individual’s representative consent to the donation of all or any of the decedent’s organs or tissues as an anatomical donation if suitable.

(ii) Directions given by a person authorized under § 4–503 of the Estates and Trusts Article to make, amend, revoke, or refuse to make an anatomical gift of a decedent’s body or parts shall be recorded in the decedent’s medical record.

(iii) The representative of the appropriate organ, tissue, or eye recovery agency or the designated requestor and the representative of the deceased patient are entitled to protection from civil and criminal liability as provided in § 4–514 of the Estates and Trusts Article.

(5) In all discussions concerning donations of organs and tissues, the representative of the appropriate organ, tissue, or eye recovery agency or the designated requestor shall show reasonable discretion and sensitivity:

(i) To the circumstances of the family of the decedent;

(ii) To the religious beliefs of the decedent; and

(iii) To the nonsuitability for organ or tissue donation of the decedent.

(6) (i) When a representative of the appropriate organ, tissue, or eye recovery agency or a designated requestor makes a request under paragraph (4)(i) of this subsection, the representative or designated requestor shall document the request and its disposition as required by § 4–508 of the Estates and Trusts Article.

(ii) Hospital personnel shall note the request and its disposition in the decedent’s medical record or death certificate.

(7) A hospital may not bill the estate of the decedent, a surviving spouse or domestic partner of the decedent, any heirs of the decedent, or an insurer of the decedent for the costs associated with the removal of all or any of the decedent’s organs or tissues for the purpose of an anatomical donation.

(8) After consultation with the Maryland Hospital Association, Inc., the Medical and Chirurgical Faculty of the State of Maryland, Living Legacy Foundation, the Washington Regional Transplant Community, the Medical Eye Bank of Maryland, the Health Facilities Association of Maryland, and Tissue Banks International, the Secretary shall publish guidelines designed to implement this subsection, including guidelines:

(i) Requiring that, at or near the time of each individual death in a hospital, the hospital contact by telephone an appropriate organ, tissue, or eye recovery agency to determine the suitability of the individual for organ, tissue, and eye donation;

(ii) Requiring that each hospital designate a person to make the contact; and

(iii) Identifying the information that the person designated by the hospital shall have available before making the contact.

(9) The provisions of this subsection shall in no way interfere with the duties of the office of the Chief Medical Examiner. In sudden deaths under the jurisdiction of the office of the Chief Medical Examiner as provided in § 5–309 of this article, notification will be made to the office of the Chief Medical Examiner prior to organ removal.

(10) The consent of the decedent’s representative is not necessary and the provisions of paragraph (4) of this subsection do not apply if § 4–506 of the Estates and Trusts Article precludes the decedent’s representative from making an anatomical gift.

(11) A person who acts in good faith to recover organs or tissues in accordance with a notation on the decedent’s driver’s license or identification card that the decedent is an organ donor, a gift made in accordance with § 5–604.1 of this article or Title 4, Subtitle 5 of the Estates and Trusts Article, or a gift made in accordance with the anatomical gift laws of another state or country is immune from criminal prosecution and liability for damages in any cause of action related to the recovery and donation of the decedent’s organs or tissues.

(12) The Department shall conduct annual death record reviews at each hospital to determine the hospital’s compliance with the provisions of this subsection. The Department may delegate its duty to conduct annual death record reviews to the appropriate organ, tissue, or eye recovery agency serving the region in which a particular hospital is located.

(b) (1) Subject to paragraph (2) of this subsection and notwithstanding any other provision of law, a hospital offering bone marrow transplant services shall allow an individual to donate bone marrow to any individual.

(2) An individual may donate bone marrow to another individual if a licensed physician determines, based on the physician’s medical judgment, that the donation of the bone marrow is in the best interests of the donee and there is no substantial risk of medical injury to the donor.