reglab/housing_qa huggingface dataset:
MD. Health - General Code Ann. §  14-501 (2021)
2021 Maryland Statutes|Health - General|Title 14 - General Day Care|Subtitle 5 - Youth Sports Programs|Section 14-501 - Concussions, Head Injuries, or Sudden Cardiac Arrest in Youth Sports Programs

    (a)    (1)    In this section the following words have the meanings indicated.        (2)    “Concussion” means a traumatic injury to the brain causing an immediate and, usually, short–lived change in mental status or an alteration of normal consciousness resulting from:            (i)    A fall;            (ii)    A violent blow to the head or body; or            (iii)    The shaking or spinning of the head or body.        (3)    “Sudden cardiac arrest” means a condition in which the heart suddenly and unexpectedly stops beating.        (4)    “Youth athlete” means an individual who participates in an athletic activity in association with a youth sports program conducted:            (i)    At a public school facility; or            (ii)    By a recreational athletic organization.        (5)    “Youth sports program” means a program organized for recreational athletic competition or instruction for participants who are under the age of 19 years.    (b)    (1)    A youth sports program shall make available information on concussions, head injuries, and sudden cardiac arrest developed by the State Department of Education under §§ 7–433 and 7–436 of the Education Article to coaches, youth athletes, and the parents or guardians of youth athletes.        (2)    A coach of a youth sports program shall review the information provided in paragraph (1) of this subsection.    (c)    (1)    A youth athlete who is suspected of sustaining a concussion or other head injury in a practice or game shall be removed from play at that time.        (2)    A youth athlete who has been removed from play may not return to play until the youth athlete has obtained written clearance from a licensed health care provider trained in the evaluation and management of concussions.    (d)    Before a youth sports program may use a facility owned or operated by a local government, the local government shall provide notice to the youth sports program of the requirements of this section.
MD. Health - General Code Ann. §  15-101.1 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-101.1 - Applicability of Other Provisions to a Managed Care Organization

    (a)    Except as otherwise provided in this subtitle, a managed care organization is not subject to the insurance laws of the State or to the provisions of Title 19 of this article.    (b)    A managed care organization may not be required to offer a qualified plan, as defined in § 31–101 of the Insurance Article, in the Maryland Health Benefit Exchange.
MD. Health - General Code Ann. §  15-102 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-102 - Indigent and Medically Indigent -- Preventive and Home Care Services; Educational Opportunities

    (a)    Subject to the limitations of the State budget, the Department shall provide preventive and home care services for indigent and medically indigent individuals.    (b)    (1)    The Program shall promote educational opportunities for recipients on:            (i)    Preventive health care;            (ii)    Good health habits; and            (iii)    The value of developing ongoing relationships with primary care and lower cost providers.        (2)    In educating Program recipients in accordance with the provisions of paragraph (1) of this subsection, the Program shall work with appropriate groups to assist in the education of Program recipients.
MD. Health - General Code Ann. §  15-102.2 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-102.2 - Applicability of Certain Provisions -- Claims of Subrogation

    (a)    Except as otherwise provided in this section, the provisions of § 19-706.1 of this article (Rehabilitation and liquidation) shall apply to managed care organizations in the same manner they apply to health maintenance organizations.    (b)    (1)    A health care provider may not assert a claim of subrogation against an enrollee of a managed care organization or the State.        (2)    Notwithstanding paragraph (1) of this subsection, a health care provider may assert any claim it may have against the receiver of the insolvent managed care organization.
MD. Health - General Code Ann. §  15-102.3 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-102.3 - Applicability of Certain Provisions -- Examination of Financial Affairs and Status

    (a)    The provisions of § 15–112(b)(1)(ii) and (2), (f) through (m), (r), (s), and (u) through (w) of the Insurance Article (Provider panels) shall apply to managed care organizations in the same manner they apply to carriers.    (b)    The provisions of § 15–1005 of the Insurance Article shall apply to managed care organizations in the same manner they apply to health maintenance organizations.    (c)    The provisions of §§ 4–311, 15–604, 15–605, and 15–1008 of the Insurance Article shall apply to managed care organizations in the same manner they apply to carriers.    (d)    (1)    The provisions of §§ 19–712(b), (c), and (d), 19–713.2, and 19–713.3 of this article apply to managed care organizations in the same manner they apply to health maintenance organizations.        (2)    The Insurance Commissioner shall consult with the Secretary before taking any action against a managed care organization under this subsection.    (e)    The provisions of § 15–112.1 of the Insurance Article apply to managed care organizations in the same manner they apply to carriers.    (f)    The Insurance Commissioner or an agent of the Commissioner shall examine the financial affairs and status of each managed care organization at least once every 5 years.    (g)    The provisions of § 15–1628.3 of the Insurance Article apply to pharmacy benefits managers that contract with managed care organizations in the same manner as they apply to pharmacy benefits managers that contract with carriers.    (h)    (1)    The provisions of § 6–102.1 of the Insurance Article apply to managed care organizations.        (2)    For each calendar year that the Insurance Commissioner assesses a health insurance provider fee under § 6–102.1 of the Insurance Article, a managed care organization shall pay the fee on a quarterly basis in accordance with a schedule adopted by the Insurance Commissioner.    (i)    The provisions of §§ 15–130 and 15–130.1 of the Insurance Article apply to managed care organizations and pharmacy benefits managers that contract with managed care organizations.
MD. Health - General Code Ann. §  15-102.5 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-102.5 - Mechanism to Provide for Equitable Distribution of Enrollees

    (a)    Subject to § 15-103(f) of this subtitle, a health maintenance organization that requires its panel providers to participate in a managed care organization shall establish a mechanism, subject to review by the Secretary, which provides for equitable distribution of enrollees and which ensures that a provider will not be assigned a disproportionate number of enrollees.    (b)    Nothing in this section may be interpreted as prohibiting a provider from voluntarily accepting additional enrollees.
MD. Health - General Code Ann. §  15-102.6 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-102.6 - Applicability of Other Provisions; Regulations

    (a)    (1)    Subject to paragraph (2) of this subsection, the provisions of Title 7 of the Insurance Article apply to managed care organizations.        (2)    Before approving a transaction under § 7–306 of the Insurance Article, the Insurance Commissioner shall consult with the Secretary.        (3)    The Insurance Commissioner:            (i)    Shall adopt regulations establishing a reporting materiality threshold; and            (ii)    May adopt regulations necessary to implement the provisions of this subsection.        (4)    The provisions of this subsection may not apply to any transaction preempted by federal law.    (b)    The provisions of Title 4, Subtitle 5 of the Insurance Article apply to managed care organizations.
MD. Health - General Code Ann. §  15-102.7 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-102.7 - Applicability of Certain Premium Tax Provisions

    The premium tax imposed under § 6-102 of the Insurance Article applies to managed care organizations.
MD. Health - General Code Ann. §  15-102.8 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-102.8 - Claims Processing Charge for Medicaid Claims Paid by Department to District of Columbia Hospitals

    (a)    The Department may impose a claims processing charge on all Medicaid claims processed, approved, and paid by the Department to hospitals located in the District of Columbia for the provision of inpatient and outpatient hospital services.    (b)    The amount to be paid under subsection (a) of this section may not exceed 6% of the amount of claims paid.    (c)    The Department shall adopt regulations to implement this section.
MD. Health - General Code Ann. §  15-103.1 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-103.1 - Promotion of Cost Effectiveness of State Health Care System

    The Program shall use its leverage as a high volume purchaser to promote the cost effectiveness of Maryland’s health care system.
MD. Health - General Code Ann. §  15-103.2 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-103.2 - Rfps for Comparing Performance and Cost of Different Managed Care Dental Programs

    (a)    The Department shall issue a request for proposals for the administration of dental services for Program recipients for the purpose of comparing and evaluating the performance and cost of dental services provided by a managed care organization and the performance and cost of dental services provided by a dental managed care organization that is separate from a managed care organization.    (b)    The Department shall provide access to Program recipients for dental services to increase utilization of dental services in accordance with utilization targets that the Department by regulation establishes in an oral health care plan.    (c)    The access required under subsection (b) of this section may be through a managed care organization or a dental managed care organization that is separate from a managed care organization.
MD. Health - General Code Ann. §  15-103.3 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-103.3 - Healthchoice Performance Incentive Fund

    (a)    There is a HealthChoice Performance Incentive Fund established in the Department.    (b)    (1)    The Department shall pay all fines collected under § 15–103(b)(12)(v) of this subtitle and penalties collected under § 15–103.7(e)(2)(iv) of this subtitle to the Comptroller of the State.        (2)    The Comptroller shall distribute the fines to the Fund.    (c)    (1)    The Fund shall be used exclusively for the provider reimbursement budget under the HealthChoice Program, including providing financial incentives designed to improve the quality of care to managed care organizations that exceed performance targets.        (2)    The Fund is a continuing nonlapsing fund not subject to § 7–302 of the State Finance and Procurement Article.        (3)    Except as provided in paragraph (4) of this subsection, any unspent portions of the Fund may not be transferred or revert to the General Fund of the State, but shall remain in the Fund to be used for the purposes specified in this section.        (4)    At the end of each fiscal year, any amount in excess of $5 million shall revert to the General Fund.    (d)    (1)    The Secretary or the Secretary’s designee shall administer the Fund.        (2)    The Secretary shall adopt regulations to carry out the provisions of this section, including the distribution of money from the Fund to managed care organizations.    (e)    The Legislative Auditor shall audit the accounts and transactions of the Fund as provided in § 2–1220 of the State Government Article.
MD. Health - General Code Ann. §  15-103.4 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-103.4 - Credentialing of Health Care Providers

    (a)    A managed care organization may deem a health care provider credentialed for a period of not more than 6 months from the date of receipt of a completed application if:        (1)    The health care provider:            (i)    Has been credentialed by another entity in the State that is required to credential health care providers; and            (ii)    Has submitted an application to participate in the managed care organization’s provider panel; and        (2)    The managed care organization verifies that the health care provider was credentialed and remains in good standing with at least one entity that credentialed the health care provider.    (b)    An entity that has credentialed a health care provider may not refuse a request by a managed care organization to verify that the health care provider is credentialed and in good standing.    (c)    Nothing in this section may be construed to relieve the managed care organization from fully credentialing its health care providers.
MD. Health - General Code Ann. §  15-103.5 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-103.5 - Rate Review and Comparison; Reports

    (a)    For the calendar year prior to the report date under subsection (b) of this section, the Department shall review the rates paid to providers under the federal Medicare fee schedule and compare the rates under the Medicare fee schedule to the fee–for–service rates paid to similar providers for the same services under the Maryland Medical Assistance Program and the rates paid to managed care organization providers for the same services under the Maryland Medical Assistance Program.    (b)    On or before January 1, 2010, and each January 1 thereafter, the Department shall report, in accordance with § 2–1257 of the State Government Article, to the Senate Finance Committee and the House Health and Government Operations Committee on:        (1)    The review and comparison under subsection (a) of this section;        (2)    Whether the fee–for–service rates and managed care organization provider rates will exceed the rates paid under the Medicare fee schedule for the period covered by the review required under subsection (a) of this section;        (3)    An analysis of the fee–for–service reimbursement rates paid in other states and how those rates compare with those in the State;        (4)    A schedule for bringing the State’s fee–for–service reimbursement rates to a level that assures that all health care providers are reimbursed adequately to provide access to care; and        (5)    An analysis of the estimated costs of implementing the schedule and any proposed changes to the fee–for–service reimbursement rates for the Maryland Medical Assistance Program and the Maryland Children’s Health Program.
MD. Health - General Code Ann. §  15-103.6 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-103.6 - Regulations to Ensure Parity of Specialty Mental Health and Substance Use Disorder Services With Federal Acts

    (a)    (1)    Subject to paragraph (2) of this subsection, on or before June 30, 2017, the Department shall adopt regulations necessary to ensure that the Program is in compliance with the federal Mental Health Parity and Addiction Equity Act and the federal Patient Protection and Affordable Care Act.        (2)    The Department is not required to adopt regulations under paragraph (1) of this subsection for any change that may be made through a process other than the regulatory process.    (b)    The regulations adopted under subsection (a) of this section shall include standards regarding treatment limitations for specialty mental health and substance use disorder services that comply with the federal Mental Health Parity and Addiction Equity Act and the federal Patient Protection and Affordable Care Act, as amended by the federal Health Care and Education Reconciliation Act of 2010, and relate to:        (1)    The scope of benefits for:            (i)    Telehealth services; and            (ii)    Residential treatment programs that are not institutions for mental disease;        (2)    Service notification and authorization requirements;        (3)    Licensed specialty mental health or substance use disorder program billing for:            (i)    Services provided by physicians, advanced practice nurses, and physician assistants;            (ii)    Services provided by a licensed specialty mental health or substance use disorder program at a location that is not the primary location at which the program is licensed; and            (iii)    Separate levels of service provided within a single day or week; and        (4)    Reimbursement rates.    (c)    The treatment limitations for specialty mental health and substance use disorder services comply with the federal Mental Health Parity and Addiction Equity Act and the federal Patient Protection and Affordable Care Act, as amended by the federal Health Care and Education Reconciliation Act of 2010, if the operable processes, strategies, evidentiary standards, or other factors used in applying a treatment limitation to specialty mental health or substance use disorder services, as written and applied, are comparable to and no more restrictive than, and are applied no more stringently than, the processes, strategies, evidentiary standards, or other factors used in applying the treatment limitation to medical and surgical services.
MD. Health - General Code Ann. §  15-104 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-104 - Contracts With Department of Human Services

    The Secretary may contract with the Department of Human Services to provide medical services to those individuals for whom:        (1)    Funds are appropriated to the Department of Human Services; and        (2)    The Department of Human Services is responsible under the appropriation.
MD. Health - General Code Ann. §  15-105.1 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-105.1 - Reimbursement Procedures Under Program -- Electronic Reimbursement

    (a)    This section does not apply to a person providing pharmacy benefit manager services.    (b)    If a pharmacy is required to submit a request for payment electronically to the Department under § 15-105(b) of this subtitle, then the pharmacy may choose to be reimbursed electronically, and in that event, the Department shall reimburse the pharmacy electronically under the Program.
MD. Health - General Code Ann. §  15-105.2 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-105.2 - Reimbursement to Health Care Providers

    (a)    The Program shall reimburse health care providers in accordance with the requirements of Title 19, Subtitle 1, Part IV of this article.    (b)    (1)    (i)    In this subsection the following words have the meanings indicated.            (ii)    “Health care provider” means a person who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program.            (iii)    1.    “Telemedicine” means, as it relates to the delivery of health care services, the use of interactive audio, video, or other telecommunications or electronic technology:                A.    By a health care provider to deliver a health care service that is within the scope of practice of the health care provider at a site other than the site at which the patient is located; and                B.    That enables the patient to see and interact with the health care provider at the time the health care service is provided to the patient.                2.    “Telemedicine” does not include:                A.    An audio–only telephone conversation between a health care provider and a patient;                B.    An electronic mail message between a health care provider and a patient; or                C.    A facsimile transmission between a health care provider and a patient.        (2)    To the extent authorized by federal law or regulation, the provisions of § 15–139(c) through (f) of the Insurance Article relating to coverage of and reimbursement for health care services delivered through telemedicine shall apply to the Program and managed care organizations in the same manner they apply to carriers.        (3)    Subject to the limitations of the State budget and to the extent authorized by federal law or regulation, the Department may authorize coverage of and reimbursement for health care services that are delivered through store and forward technology or remote patient monitoring.        (4)    (i)    The Department may specify by regulation the types of health care providers eligible to receive reimbursement for health care services provided to Program recipients under this subsection.            (ii)    If the Department specifies by regulation the types of health care providers eligible to receive reimbursement for health care services provided to Program recipients under this subsection, the types of health care providers specified shall include primary care providers.        (5)    The Department may require a health care provider to submit a registration form to the Department that includes information required for the processing of claims for reimbursement for health care services provided to Program recipients under this subsection.        (6)    The Department shall adopt regulations to carry out this subsection.
MD. Health - General Code Ann. §  15-106 (2021)
2021 Maryland Statutes|Health - General|Title 15 - Assistance Programs|Subtitle 1 - Medical and Pharmacy Assistance Programs|Section 15-106 - Review of Health Care Under Program

    (a)    (1)    In cooperation with the professional organizations whose members provide health care under the Program, the Secretary shall establish a system of review for all health care that is provided.        (2)    The review shall include a study of the quality of care and the proper use of the services by the Program recipient or the provider.    (b)    A member of an appointed committee of any of these professional organizations or an appointed member of a committee of a medical staff of a licensed hospital shall have the immunity from liability described under § 5-628 of the Courts and Judicial Proceedings Article.