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<section article="ghg" article_name="Health - General" number="19-145.1" 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">
      <level label="i">
        <text>“Advance care planning document” means a document that indicates an individual’s preferences for the receipt of health care.</text>
      </level>
      <level label="ii">
        <text>“Advance care planning document” includes:</text>
        <level label="1">
          <text>An advance directive; and</text>
        </level>
        <level label="2">
          <text>A Medical Orders for Life–Sustaining Treatment form.</text>
        </level>
      </level>
    </level>
    <level label="3">
      <text>“Carrier” means:</text>
      <level label="i">
        <text>An insurer;</text>
      </level>
      <level label="ii">
        <text>A nonprofit health service plan; and</text>
      </level>
      <level label="iii">
        <text>A health maintenance organization.</text>
      </level>
    </level>
    <level label="4">
      <text>“Electronic advance care planning document” means an electronic version of an advance care planning document that is able to be uploaded or saved to the electronic platform developed under subsection (b)(2)(i) of this section.</text>
    </level>
    <level label="5">
      <text>“Health care provider” means:</text>
      <level label="i">
        <text>A health care practitioner who is licensed or certified under the Health Occupations Article to provide health care in the ordinary course of business;</text>
      </level>
      <level label="ii">
        <text>A set of health care practitioners, as defined in § 15–113 of this article;</text>
      </level>
      <level label="iii">
        <text>A health care facility as defined in § 19–114 of this subtitle;</text>
      </level>
      <level label="iv">
        <text>A nursing facility, as defined in § 19–301 of this title; or</text>
      </level>
      <level label="v">
        <text>An assisted living program, as defined in § 19–1801 of this title.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <level label="1">
      <text>The Commission shall coordinate the accessibility of electronic advance care planning documents in the State.</text>
    </level>
    <level label="2">
      <text>The coordination provided by the Commission under this subsection shall include:</text>
      <level label="i">
        <text>Collaboration with the State–designated health information exchange to develop an electronic platform through which:</text>
        <level label="1">
          <text>Individuals can upload or save advance care planning documents;</text>
        </level>
        <level label="2">
          <text>Individuals can update electronic advance care planning documents; and</text>
        </level>
        <level label="3">
          <text>Health care providers can access electronic advance care planning documents as appropriate;</text>
        </level>
      </level>
      <level label="ii">
        <text>Identification of options meeting federal, State, and industry cybersecurity standards that may be taken by carriers, managed care organizations, and health care providers to:</text>
        <level label="1">
          <text>Encourage members, enrollees, and patients to create, upload or save, and update advance care planning documents; and</text>
        </level>
        <level label="2">
          <text>Make tools, which may include electronic advance directives services recognized by the Commission under § 19–144 of this subtitle, accessible to members, enrollees, and patients that allow them to create, upload or save, and update electronic advance care planning documents;</text>
        </level>
      </level>
      <level label="iii">
        <text>Development and implementation of quality measures endorsed or designated for testing by a national quality measurement organization to measure the effectiveness of the options identified under item (ii) of this paragraph; and</text>
      </level>
      <level label="iv">
        <text>Inclusion of a distinct tab on the State–designated health information exchange website that provides:</text>
        <level label="1">
          <text>Access to the advance directive information sheet developed under § 5–615 of this article;</text>
        </level>
        <level label="2">
          <text>The electronic means to create, execute, and store an advance directive or health care designation; and</text>
        </level>
        <level label="3">
          <text>The capability to upload or save an advance care planning document to the electronic platform developed in accordance with item (i) of this paragraph and update existing electronic advance care planning documents.</text>
        </level>
      </level>
    </level>
    <level label="3">
      <text>As the Commission identifies options under paragraph (2)(ii) of this subsection, the Commission may explore whether carriers, managed care organizations, and health care providers with secure member authentication websites can link between the website of the carrier, managed care organization, or health care provider and the State–designated health information exchange website.</text>
    </level>
    <level label="4">
      <text>In developing the electronic platform in accordance with paragraph (2)(i) of this subsection, the Commission and the State–designated health information exchange:</text>
      <level label="i">
        <text>Shall consult with other State agencies and stakeholders, as appropriate; and</text>
      </level>
      <level label="ii">
        <text>Subject to available funds, may contract with a third–party vendor, as appropriate.</text>
      </level>
    </level>
    <level label="5">
      <text>The electronic platform developed in accordance with paragraph (2)(i) of this subsection shall:</text>
      <level label="i">
        <text>Provide an individual with disabilities with nonvisual access in a way that is fully and equally accessible to and independently usable by the individual with disabilities so that the individual is able to acquire the same information, engage in the same interactions, and enjoy the same services as users without disabilities, with substantially equivalent ease of use; and</text>
      </level>
      <level label="ii">
        <text>Be consistent with the standards of § 508 of the federal Rehabilitation Act of 1973.</text>
      </level>
    </level>
  </level>
  <level label="c">
    <text>As an option under subsection (b)(2)(ii) of this section, a carrier, managed care organization, or health care provider may contract with an electronic advance directives service if the service:</text>
    <level label="1">
      <text>Is approved by the Maryland Health Care Commission under § 19–144 of this subtitle; and</text>
    </level>
    <level label="2">
      <text>Meets the technology, security, and privacy standards set by the Commission.</text>
    </level>
  </level>
  <level label="d">
    <text>The Commission may adopt regulations to carry out this section.</text>
  </level>
</section>
