2013 Maryland Code
INSURANCE
§ 15-1902 - Contract between carrier and a clinically integrated organization


MD Ins Code § 15-1902 (2013) What's This?

§15-1902.

(a) Notwithstanding any other provision of this article or the Health - General Article, a contract between a carrier and a clinically integrated organization may include a provision to pay:

(1) for services associated with the coordination of covered medical services to qualifying individuals; and

(2) a bonus, fee-based incentive, bundled fees, or other incentives to promote the efficient, medically appropriate delivery of covered medical services to qualifying individuals.

(b) The Commissioner, in consultation with the Maryland Health Care Commission, may adopt regulations specifying the types of payments and incentives permissible under this section.

(c) (1) A carrier shall file a copy of a contract between the carrier and a clinically integrated organization with the Commissioner.

(2) If the contract includes a provision to pay a bonus or other incentive that does not comply with § 15-113 of this title, the Commissioner shall provide a copy of the contract to the executive director of the Maryland Health Care Commission.

(3) Notwithstanding any other provision of law, a copy of a contract filed with the Commissioner or provided by the Commissioner to the executive director of the Maryland Health Care Commission under this subsection, is:

(i) confidential and privileged;

(ii) not subject to:

1. Title 10, Subtitle 6 of the State Government Article;

2. subpoena; or

3. discovery; and

(iii) not admissible in evidence in any private action.

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