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<section article="ghg" article_name="Health - General" number="19-108.3" title_number="19" title_name="Health Care Facilities" subtitle_number="1" subtitle_name="Health Care Planning and Systems Regulation">
  <level label="a">
    <level label="1">
      <text>In this section the following words have the meanings indicated.</text>
    </level>
    <level label="2">
      <text>“Carrier” includes insurers, nonprofit health service plans, health maintenance organizations, third–party administrators, and pharmacy benefits managers.</text>
    </level>
    <level label="3">
      <text>“Health care provider” includes hospitals, physicians, nurse practitioners, pharmacists, and other persons entitled to reimbursement under § 15–701(a) of the Insurance Article.</text>
    </level>
    <level label="4">
      <text>“Workgroup” means the Health Care Provider–Carrier Workgroup.</text>
    </level>
  </level>
  <level label="b">
    <text>The Commission shall establish a Health Care Provider–Carrier Workgroup.</text>
  </level>
  <level label="c">
    <text>The purpose of the Workgroup is to provide a mechanism for health care providers and carriers to resolve disputes on issues over which no State agency has statutory or regulatory authority.</text>
  </level>
  <level label="d">
    <text>The Workgroup shall be composed of representatives of:</text>
    <level label="1">
      <text>Professional organizations or associations of health care providers who bill and receive reimbursement for health care services from carriers;</text>
    </level>
    <level label="2">
      <text>Carriers or organizations or trade associations representing carriers that reimburse health care providers for health care services provided under health benefit plans; and</text>
    </level>
    <level label="3">
      <text>Subject to subsection (e)(1)(iii) of this section, consumer organizations.</text>
    </level>
  </level>
  <level label="e">
    <level label="1">
      <text>The Commission shall invite the following to appoint members to the Workgroup:</text>
      <level label="i">
        <text>Professional organizations or associations of health care providers;</text>
      </level>
      <level label="ii">
        <text>Carriers or organizations or trade associations representing carriers; and</text>
      </level>
      <level label="iii">
        <text>When appropriate to the issue under discussion, consumer organizations.</text>
      </level>
    </level>
    <level label="2">
      <text>Membership in the Workgroup may change depending on the issues before the Workgroup.</text>
    </level>
    <level label="3">
      <text>The size of the Workgroup shall be at the discretion of the Commission but large enough to represent the appropriate range of stakeholders.</text>
    </level>
  </level>
  <level label="f">
    <text>Workgroup members may not receive compensation or reimbursement for serving on the Workgroup.</text>
  </level>
  <level label="g">
    <text>The Workgroup shall meet at least quarterly.</text>
  </level>
  <level label="h">
    <text>Commission staff shall facilitate Workgroup meetings and provide research and other support to the Workgroup.</text>
  </level>
  <level label="i">
    <level label="1">
      <text>At least annually, Commission staff shall solicit issues for consideration by the Workgroup.</text>
    </level>
    <level label="2">
      <text>Issues shall be solicited from:</text>
      <level label="i">
        <text>Members of the General Assembly;</text>
      </level>
      <level label="ii">
        <text>Professional organizations or associations of health care providers and carriers or organizations or trade associations representing carriers;</text>
      </level>
      <level label="iii">
        <text>State agencies, including the Department, health occupations boards, the Maryland Insurance Administration, and the Commission; and</text>
      </level>
      <level label="iv">
        <text>Consumer organizations.</text>
      </level>
    </level>
  </level>
  <level label="j">
    <text>After soliciting issues under subsection (i) of this section, Commission staff shall select the issues to be considered by the Workgroup.</text>
  </level>
  <level label="k">
    <text>Commission staff shall:</text>
    <level label="1">
      <text>Research each issue before the issue is considered by the Workgroup;</text>
    </level>
    <level label="2">
      <text>Use the results of the research to inform Workgroup meetings;</text>
    </level>
    <level label="3">
      <text>Facilitate Workgroup meetings in a way that promotes resolution of disputes on issues and is satisfactory to the members of the Workgroup; and</text>
    </level>
    <level label="4">
      <text>On or before January 1, 2016, and each year thereafter, submit a report to the Commission and, in accordance with § 2–1257 of the State Government Article, the Senate Finance Committee and the House Health and Government Operations Committee regarding the issues considered by the Workgroup during the preceding year and the outcome of the Workgroup’s consideration of each issue.</text>
    </level>
  </level>
</section>
