2013 Maryland Code
HEALTH - GENERAL
§ 19-1A-02 - In general [Subtitle subject to abrogation]


MD Health-Gen Code § 19-1A-02 (2013) What's This?

(a) Established. -- Subject to § 19-1A-03(a) of this subtitle, the Commission shall establish the Maryland Patient Centered Medical Home Program to promote development of patient centered medical homes.

(b) Participation. --

(1) A carrier may elect to participate in the Maryland Patient Centered Medical Home Program.

(2) Notwithstanding the provisions of paragraph (1) of this subsection, a prominent carrier shall participate in the Maryland Patient Centered Medical Home Program.

(3) Subject to the limitations of the State budget, the Department:

(i) May require that certain managed care organizations participate in the Maryland Patient Centered Medical Home Program as allowed by law; and

(ii) Notwithstanding any other provision of this article, may mandate the participation in the Maryland Patient Centered Medical Home Program of Maryland Medical Assistance Program enrollees.

(4) The Department shall ensure that participation in the Maryland Patient Centered Medical Home Program of managed care organizations and Maryland Medical Assistance Program enrollees shall support the quality and efficiency standards established in the HealthChoice Program.

(c) Authorization to implement single carrier patient centered medical home program. -- The Commission may also authorize a carrier to implement a single carrier patient centered medical home program that:

(1) Pays and shares medical information with a patient centered medical home in accordance with § 15-1802 of the Insurance Article; and

(2) Conforms with the principles of the patient centered medical home as adopted by a national coalition of physicians, carriers, purchasers, and consumers.

(d) Incentive-based compensation. -- Nothing in this section shall be construed to limit or prohibit a carrier from providing a bonus, fee based incentives, bundled incentives, or other incentive-based compensation:

(1) As authorized by the Commission for a patient centered medical home; or

(2) As allowed under § 15-113 of the Insurance Article.

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