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Statutes Text

Article - Insurance


    Notwithstanding any other provision of this article or the Health – General Article, a carrier shall share medical information about a qualifying individual with a clinically integrated organization and its members if:

        (1)    the carrier has a written agreement with the clinically integrated organization specifying the type and proposed use of medical information to be shared;

        (2)    the medical information is used by the clinically integrated organization to:

            (i)    promote the efficient, medically appropriate delivery of covered medical services to qualifying individuals;

            (ii)    coordinate care, including efforts to coordinate, plan, develop, monitor, share information related to, and otherwise initiate a treatment plan for a qualifying individual;

            (iii)    perform the functions of a medical review committee as described in § 1–401(c) of the Health Occupations Article; or

            (iv)    offer or provide covered medical services or seek payment for or evaluate covered medical services provided by the members of the clinically integrated organization; and

        (3)    the clinically integrated organization or the carrier implements procedures for disclosing to qualifying individuals how the clinically integrated organization and the carrier share medical information to deliver more coordinated, higher quality care.

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