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Statutes Text

Article - Insurance




§31–106.

    (a)    Subject to any limitations under this title or other applicable law, the Board shall have all powers necessary or convenient to carry out the functions authorized by the Affordable Care Act and consistent with the purposes of the Exchange.

    (b)    The enumeration of specific powers in this title is not intended to restrict the Board’s power to take any lawful action that the Board determines is necessary or convenient to carry out the functions authorized by the Affordable Care Act and consistent with the purposes of the Exchange.

    (c)    (1)    In addition to the powers set forth elsewhere in this title, the Board may:

            (i)    adopt and alter an official seal;

            (ii)    sue, be sued, plead, and be impleaded;

            (iii)    adopt bylaws, rules, and policies;

            (iv)    subject to paragraph (2) of this subsection, adopt regulations to carry out this title:

                1.    in accordance with Title 10, Subtitle 1 of the State Government Article; and

                2.    without conflicting with or preventing application of regulations adopted by the Secretary under Title 1, Subtitle D of the Affordable Care Act;

            (v)    maintain an office at the place designated by the Board;

            (vi)    enter into any agreements or contracts and execute the instruments necessary or convenient to manage its own affairs and carry out the purposes of this title;

            (vii)    apply for and receive grants, contracts, or other public or private funding; and

            (viii)    do all things necessary or convenient to carry out the powers granted by this title.

        (2)    Unless waived by the chairs of the committees, at least 30 days before submitting any proposed regulation to the Maryland Register for publication, the Board shall submit the proposed regulation to the Senate Finance Committee and the House Health and Government Operations Committee.

    (d)    (1)    To carry out the purposes of this title or perform any of its functions under this title, the Board may contract or enter into memoranda of understanding with eligible entities, including:

            (i)    the Maryland Medical Assistance Program;

            (ii)    the family investment unit of the Department of Human Services;

            (iii)    insurance producers and third party administrators registered in the State; and

            (iv)    any other entities that have experience in individual and small group public and private health insurance plans or facilitating enrollment in those plans.

        (2)    The operations of the Exchange are subject to the provisions of this title whether the operations are performed directly by the Exchange or through an entity under a contract with the Exchange.

        (3)    The Board shall ensure that any entity under a contract with the Exchange complies with the provisions of this title when performing services that are subject to this title on behalf of the Exchange.

    (e)    (1)    The Board may enter into information–sharing agreements with federal and state agencies, and other state health insurance exchanges, to carry out the provisions of this title.

        (2)    An information–sharing agreement entered into under paragraph (1) of this subsection shall:

            (i)    include adequate protections with respect to the confidentiality of information; and

            (ii)    comply with all State and federal laws and regulations.

    (f)    (1)    The Board, in accordance with Title 12, Subtitle 4 of the State Finance and Procurement Article, shall adopt written policies and procedures governing all procurements of the Exchange.

        (2)    To the fullest extent practicable, and in a manner that does not impair the Exchange’s ability to carry out the purposes of this title, the Board’s procurement policies and procedures shall establish an open and transparent process that:

            (i)    promotes public confidence in the procurements of the Exchange;

            (ii)    ensures fair and equitable treatment of all persons and entities that participate in the procurement system of the Exchange;

            (iii)    fosters appropriate competition and provides safeguards for maintaining a procurement system of quality and integrity;

            (iv)    promotes increased economic efficiency and responsibility on the part of the Exchange;

            (v)    achieves the maximum benefit from the purchasing power of the Exchange; and

            (vi)    provides clarity and simplicity in the rules and procedures governing the procurements of the Exchange.

    (g)    (1)    To carry out the purposes of this title, the Board shall:

            (i)    create and consult with ad hoc advisory committees; and

            (ii)    appoint to the ad hoc advisory committees representatives of:

                1.    insurers or health maintenance organizations offering health benefit plans in the State;

                2.    nonprofit health service plans offering health benefit plans in the State;

                3.    licensed health insurance producers and advisers;

                4.    third–party administrators;

                5.    health care providers, including:

                A.    hospitals;

                B.    long–term care facilities;

                C.    mental health providers;

                D.    developmental disability providers;

                E.    substance abuse treatment providers;

                F.    Federally Qualified Health Centers;

                G.    physicians;

                H.    nurses;

                I.    experts in services and care coordination for criminal and juvenile justice populations;

                J.    licensed hospice providers; and

                K.    other health care professionals;

                6.    managed care organizations;

                7.    employers, including large, small, and minority–owned employers;

                8.    public employee unions, including public employee union members who are caseworkers in local departments of social services with direct knowledge of information technology systems used for Medicaid eligibility determination;

                9.    consumers, including individuals who:

                A.    reside in lower–income and racial or ethnic minority communities;

                B.    have chronic diseases or disabilities; or

                C.    belong to other hard–to–reach or special populations;

                10.    individuals with knowledge and expertise in advocacy for consumers described in item 9 of this item;

                11.    public health researchers and other academic experts with knowledge and background relevant to the functions and goals of the Exchange, including knowledge of the health needs and health disparities among the State’s diverse communities; and

                12.    any other stakeholders identified by the Exchange as having knowledge or representing interests relevant to the functions and duties of the Exchange.

        (2)    In addition to the ad hoc advisory committees created under paragraph (1) of this subsection, the Board, on or before March 15, 2014, shall create a standing advisory committee that:

            (i)    consists of members who, to the extent practicable:

                1.    reflect the gender, racial, ethnic, and geographic diversity of the State;

                2.    constitute a diverse cross–section of stakeholders broadly representative of the individuals and entities described in paragraph (1)(ii) of this subsection; and

                3.    are appointed by the Board for a term of no more than 3 years in a manner that provides continuity and rotation;

            (ii)    has a liaison to the Board who is a member of the Board and is appointed by the chair of the Board; and

            (iii)    is charged with the responsibility of addressing the broad range of policy issues:

                1.    on which the Board may seek its input and advice; and

                2.    that may be proposed by the liaison to the Board, in consultation with the standing advisory committee chair and members.